Healthcare Provider Details

I. General information

NPI: 1437070091
Provider Name (Legal Business Name): EMARI WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 HERRICK AVE NE
GRAND RAPIDS MI
49505-4866
US

IV. Provider business mailing address

433 N BUTLER BLVD
LANSING MI
48915-1836
US

V. Phone/Fax

Practice location:
  • Phone: 616-262-3524
  • Fax:
Mailing address:
  • Phone: 616-262-3523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: