Individual
ANNA DERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 36TH ST SE, GRAND RAPIDS, MI 49512-2809
(616) 726-5165
Mailing address
3333 36TH ST SE, GRAND RAPIDS, MI 49512-2809
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
28243182A
IN
Other
Enumeration date
06/16/2018
Last updated
06/16/2018
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