Individual
THERESA SHEHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 R W BERENDS DR SW, WYOMING, MI 49519-4955
(616) 726-4463
Mailing address
19688 190TH AVE, BIG RAPIDS, MI 49307-8992
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703104316
MI
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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