Individual
MRS. AMELIA ROSE GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, NP-C
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Mailing address
259 MORRIS AVE SE, GRAND RAPIDS, MI 49503-4603
(616) 460-2992
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
4704305033
MI
207R00000X
Internal Medicine Physician
4704305033
MI
2084P0800X
Psychiatry Physician
Primary
4704305033
MI
Other
Enumeration date
08/29/2019
Last updated
12/18/2020
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