Individual
KIMBERLY SUE AGIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3230 EAGLE PARK DR NE, SUITE 101, GRAND RAPIDS, MI 49525-7007
(616) 954-0600
Mailing address
2218 GODWIN AVE SE, GRAND RAPIDS, MI 49507-3130
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704249140
MI
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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