Individual
CYNTHIA ANN UTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3641 BYRON CENTER AVE SW, WYOMING, MI 49519-3665
(616) 531-3070
(616) 351-2685
Mailing address
1116 CARRIER CREEK BLVD NE, GRAND RAPIDS, MI 49503-1215
(616) 458-6901
(616) 351-2685
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
4704114498
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4839885
—
MI
Enumeration date
11/01/2006
Last updated
07/09/2007
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