Individual
TARA LYNN ROCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
(616) 774-8789
(616) 776-1305
Mailing address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
(616) 774-8789
(616) 776-1305
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703123485
MI
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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