Individual
MRS. KATIE LOUISE CRELLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E PARIS AVE SE STE 200, GRAND RAPIDS, MI 49546-8383
(616) 685-3450
Mailing address
1931 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2110
(701) 590-1513
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704322754
MI
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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