Individual
KIMBERLY KAY GRIEWAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17221 MANITOU ROAD, ADDISON, MI 49220
(517) 206-2394
Mailing address
PO BOX 143, MANITOU BEACH, MI 49253-0143
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
Primary
230015914320812
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7897473
—
MI
Enumeration date
09/12/2019
Last updated
09/12/2019
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