Individual
MS. SUZANNE M. VAN WIEREN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
71 S FRONT ST, GRANT, MI 49327-9701
(231) 834-5676
(231) 834-7211
Mailing address
71 S FRONT ST, GRANT, MI 49327-9701
(231) 834-5676
(231) 834-7211
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704126331
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2934830
—
MI
Enumeration date
07/08/2005
Last updated
07/09/2007
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