Individual
SHERYL SUE BOURZAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
96 E 120TH ST, GRANT, MI 49327-8502
(231) 834-0444
(231) 834-0200
Mailing address
96 E 120TH ST, GRANT, MI 49327-8502
(231) 834-0444
(231) 834-0200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704180870
MI
363LF0000X
Family Nurse Practitioner
71002015A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200801560
—
IN
Enumeration date
01/05/2006
Last updated
01/04/2013
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