Individual
DR. RACHEL ANNE PRUDHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Contact information
Practice address
2730 5 MILE RD NE, GRAND RAPIDS, MI 49525-6518
(616) 426-9401
Mailing address
22234 220TH AVE, PARIS, MI 49338-9455
(231) 742-0117
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704309686
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704309686
MI
Other
Enumeration date
02/09/2015
Last updated
11/10/2022
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