Individual
LAURA RAE SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4069 LAKE DR SE, GRAND RAPIDS, MI 49546-8816
(616) 267-7469
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704425190
MI
Other
Enumeration date
01/18/2021
Last updated
09/15/2025
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