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Individual

EMILY FOWLER BEMBEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
72 SHELDON AVE SE, GRAND RAPIDS, MI 49503-4234
(616) 331-9830
Mailing address
72 SHELDON AVE SE, GRAND RAPIDS, MI 49503-4234
(650) 814-1276

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
163W00000X
Registered Nurse
2475459
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6704
MN

Other

Enumeration date
06/23/2014
Last updated
04/12/2021
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