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Individual

MS. SUSAN OWEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
300 LAFAYETTE AVE SE, SUITE 2045, GRAND RAPIDS, MI 49503-4650
(616) 685-3098
(616) 685-3095
Mailing address
300 LAFAYETTE AVE SE, SUITE 2045, GRAND RAPIDS, MI 49503-4650

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704131097
MI

Other

Enumeration date
11/17/2009
Last updated
11/17/2009
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