Individual
SANDRA L BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3535 PARK ST, SUITE 110, MUSKEGON, MI 49444-3736
(231) 733-3155
(231) 737-1535
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 727-4444
(231) 727-4451
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704110400
MI
Other
Enumeration date
03/17/2006
Last updated
02/07/2011
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