Individual
MISS DENISE MARIE SKONIECZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2100 RAYBROOK ST SE, SUITE #200, GRAND RAPIDS, MI 49546-7759
(616) 956-9440
(616) 954-1520
Mailing address
2100 RAYBROOK ST SE, SUITE #200, GRAND RAPIDS, MI 49546-7759
(616) 956-9440
(616) 954-1520
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
4704202151
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704202151
MI
Other
Enumeration date
05/15/2013
Last updated
12/05/2017
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