Individual
MS. DEBRA BOSSENBROEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1211 LAFAYETTE AVE NE, GRAND RAPIDS, MI 49505-5092
(616) 336-8800
(616) 336-9700
Mailing address
1211 LAFAYETTE AVE NE, GRAND RAPIDS, MI 49505-5092
(616) 336-8800
(616) 336-9700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704159159
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049587
—
MI
Enumeration date
04/23/2007
Last updated
06/14/2016
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