Individual
ANGELA KUKLEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
600 MONROE AVENUE NW, STE 104, GRAND RAPIDS, MI 49503-1470
(616) 366-4234
(855) 548-4481
Mailing address
8348 LITTLE ROAD, STE 149, NEW PORT RICHEY, FL 34654-4919
(616) 366-4234
(855) 548-4481
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704229854
MI
Other
Enumeration date
05/11/2015
Last updated
03/19/2024
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