Individual
DEE SIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6207 HARVEY ST, SUITE A, NORTON SHORES, MI 49444-7861
(231) 672-2201
(231) 672-2231
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 727-4444
(231) 728-4789
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704176401
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4745377
—
MI
Enumeration date
12/23/2005
Last updated
01/20/2017
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