Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Feb 4, 2021
License(s)
4704300284 (MI), 4704300284 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1215 E MICHIGAN AVE | Lansing, MI 48912-1811 | 517-364-1000 |
| MAILING | 1215 E MICHIGAN AVE | Lansing, MI 48912-1811 | 517-364-1000 |
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