Individual
HERMINA HENDRIKA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
230 MICHIGAN ST NE, SUITE 230, GRAND RAPIDS, MI 49503-2550
(616) 774-2822
(616) 391-8665
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704158724
MI
363LF0000X
Family Nurse Practitioner
Primary
4704158724
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4900311
—
MI
01
—
500D111930 / 0876598
BCBSM
MI
Enumeration date
07/25/2006
Last updated
10/29/2013
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