Individual
JEANNINE POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3536 QUEBEC TRL, WAYLAND, MI 49348-1409
(616) 890-1604
Mailing address
3536 QUEBEC TRL, WAYLAND, MI 49348-1409
(616) 890-1604
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703109884
MI
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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