Individual
CARLY DELSA TEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
145 MICHIGAN ST NE STE 6300, GRAND RAPIDS, MI 49503-2562
(616) 486-6000
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704416651
MI
Other
Enumeration date
03/17/2021
Last updated
09/09/2024
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