Individual
MIKAELA GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4239 S CASTLE RIDGE DR SE APT 129, GRAND RAPIDS, MI 49508-8841
(616) 498-3005
Mailing address
4239 S CASTLE RIDGE DR SE APT 129, GRAND RAPIDS, MI 49508-8841
(616) 498-3005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704371633
MI
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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