Individual
LADY YOHANNA RAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1550 CLINTON ST, MUSKEGON, MI 49442-5007
(231) 737-1335
Mailing address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
(231) 737-1335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4704306463
MI
207R00000X
Internal Medicine Physician
5013335
NC
363LF0000X
Family Nurse Practitioner
23217
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841840303
—
MI
Enumeration date
09/17/2019
Last updated
10/12/2023
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