Individual
PEGGY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2541 BARFIELD DR SE, GRAND RAPIDS, MI 49546-5577
(312) 479-5224
Mailing address
2541 BARFIELD DR SE, GRAND RAPIDS, MI 49546-5577
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704264163
MI
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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