Individual
ANDREA GILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3230 EAGLE PARK DR NE, 101, GRAND RAPIDS, MI 49525-7007
(616) 954-0600
(616) 954-1675
Mailing address
1642 KINNEY AVE NW, WALKER, MI 49534-2110
(616) 481-7898
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704231863
MI
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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