Individual
ERICA GUASTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 BAYNTON AVE NE, GRAND RAPIDS, MI 49503-3747
(616) 550-9689
Mailing address
145 BAYNTON AVE NE, GRAND RAPIDS, MI 49503-3747
(616) 550-9689
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704345959
MI
Other
Enumeration date
06/14/2023
Last updated
10/23/2024
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