Individual
KELLY GORSUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2303 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49507-3780
(616) 965-8390
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704212112
MI
Other
Enumeration date
11/13/2024
Last updated
01/10/2025
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