Individual
IGUELLE BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1001 MEDICAL PARK DR SE, GRAND RAPIDS, MI 49546-3610
(616) 929-3617
Mailing address
6920 KALAMAZOO AVE SE, CALEDONIA, MI 49316-8413
(616) 929-3617
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704282267
MI
Other
Enumeration date
06/20/2022
Last updated
03/21/2024
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