Individual
LESLIE KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8904 CEDAR LAKE DR, JENISON, MI 49428-9462
(616) 443-7934
Mailing address
3097 PRAIRIE ST SW, GRANDVILLE, MI 49418-2000
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704260532
MI
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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