Individual
REBECCA JO NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
770 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-8602
(616) 272-3533
(616) 259-4839
Mailing address
801 ROSEHILL RD, JACKSON, MI 49202-1762
(517) 212-2008
(517) 212-9023
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704322661
MI
Other
Enumeration date
07/20/2020
Last updated
09/30/2024
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