Individual
SARAH MARIE VANDEN BERGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5602
Mailing address
6143 SUMMERHILL CT, HUDSONVILLE, MI 49426-8913
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704275262
MI
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-134672
ZZ
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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