Individual
MRS. SHELLY JANE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9756
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704223822
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4688421
—
MI
Enumeration date
08/22/2006
Last updated
12/17/2025
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