Individual
KATHERINE DEFOUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
230 MICHIGAN ST NE, SUITE 230, GRAND RAPIDS, MI 49503-2550
(616) 774-2822
(616) 391-8665
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704251605
MI
Other
Enumeration date
07/17/2014
Last updated
03/02/2021
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