Individual
BEVERLY ANN BOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2111 12 MILE RD NW, SPARTA, MI 49345-9754
(616) 391-8470
(616) 391-8495
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704134193
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA8440
RAILROAD MEDICARE PTAN
MI
Enumeration date
08/07/2008
Last updated
09/01/2021
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