Individual
DEVON SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
233 FULTON ST E STE 114, GRAND RAPIDS, MI 49503-3261
(616) 648-7689
Mailing address
4666 EAGLE DR, CALEDONIA, MI 49316-9335
(616) 648-7689
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
4704314609
MI
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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