Individual
LEAH JEAN MAGNUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1131 IONIA AVE NW, GRAND RAPIDS, MI 49503-1020
(616) 259-7900
(616) 259-7909
Mailing address
316 NORTHWEST XING, HOLLAND, MI 49423-9252
(616) 780-8663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704297314
MI
363L00000X
Nurse Practitioner
Primary
4704297314
MI
Other
Enumeration date
01/09/2017
Last updated
08/14/2019
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