Individual
ANNELISE CLAERR GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
145 MICHIGAN ST NE STE 6300, GRAND RAPIDS, MI 49503-2562
(616) 486-6000
Mailing address
100 MICHIGAN ST. NE, MC 845, GRAND RAPIDS, MI 49503
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704273262
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704273262
MI
Other
Enumeration date
01/29/2022
Last updated
03/28/2022
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