Individual
LINDA E HUIZENGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1111 LEFFINGWELL AVE NE, SUITE 100, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Mailing address
1111 LEFFINGWELL AVE NE, SUITE 100, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003834
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D14869
MEDICARE ID
MI
Enumeration date
08/16/2006
Last updated
05/19/2008
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