Individual
MISS MARY ELIZABETH BLAUW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
970 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-8302
(616) 949-4840
(616) 494-3531
Mailing address
970 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-8302
(616) 949-4840
(616) 494-3531
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704274998
MI
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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