Individual
HEATHER JOY MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
145 MICHIGAN ST NE STE 5120, GRAND RAPIDS, MI 49503-2567
(616) 486-6314
(616) 486-6182
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704254589
MI
Other
Enumeration date
09/13/2012
Last updated
11/02/2021
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