Individual
KALLIE RAE KRAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4118 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-3605
(616) 486-7093
Mailing address
1809 EDGEWOOD AVE SE, GRAND RAPIDS, MI 49506-5112
(616) 723-7491
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704280159
MI
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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