Individual
ANGELA DENESE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1344 NORTHFIELD AVE NE, GRAND RAPIDS, MI 49505-5242
(616) 752-9711
Mailing address
1344 NORTHFIELD AVE NE, GRAND RAPIDS, MI 49505-5242
(616) 752-9711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111264
MI
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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