Individual
PHYLLIS MARIE DEHAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
336 S RIVER AVE, HOLLAND, MI 49423-3326
(616) 394-3788
(616) 394-3796
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
47041008280
MI
Other
Enumeration date
05/01/2007
Last updated
05/31/2016
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