Individual
KIM FIFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11652 W GRAND RIVER AVE, LOWELL, MI 49331-8465
(616) 248-5147
Mailing address
365 RIVER PL, LOWELL, MI 49331-9058
(616) 340-1974
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703114708
MI
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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