Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Gerontology
Enumerated
Nov 19, 2020
License(s)
4704287117 (MI), 4704287117 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 40412 | Belfast, ME 04915-1255 | 248-824-6500 |
| LOCATION | 2205 JOLLY RD STE B | Okemos, MI 48864-3983 | 517-347-4085 |
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