Individual
JERRICA KALLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, CPNP-PC
Contact information
Practice address
72 SHELDON AVE SE, GRAND RAPIDS, MI 49503-4234
(616) 331-9830
(616) 331-9835
Mailing address
72 SHELDON AVE SE, GRAND RAPIDS, MI 49503-4234
(616) 331-9830
(616) 331-9835
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704369106
MI
363LF0000X
Family Nurse Practitioner
RN262199
GA
363LP0200X
Pediatric Nurse Practitioner
4704369106
MI
363LP0200X
Pediatric Nurse Practitioner
RN262199
GA
Other
Enumeration date
08/13/2018
Last updated
07/11/2023
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