Individual
MRS. REBECCA K BAKER MARRIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP-BC
Contact information
Practice address
770 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-8602
(616) 272-3533
(616) 259-4839
Mailing address
801 ROSEHILL RD, JACKSON, MI 49202-1762
(517) 212-2008
(517) 212-9023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704335942
MI
163W00000X
Registered Nurse
RN.0165656
CO
363LA2100X
Acute Care Nurse Practitioner
4704335942
MI
363LF0000X
Family Nurse Practitioner
Primary
4704335942
MI
Other
Enumeration date
12/27/2017
Last updated
03/12/2024
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