Healthcare Provider Details

I. General information

NPI: 1063284396
Provider Name (Legal Business Name): CLAUDIA K HALLBERG B.S ENG.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 MONROE AVE NW STE 140
GRAND RAPIDS MI
49505-4609
US

IV. Provider business mailing address

664 EMERALD LAKE DRIVE
NEWAYGO MI
49337
US

V. Phone/Fax

Practice location:
  • Phone: 616-458-9520
  • Fax:
Mailing address:
  • Phone: 231-652-1921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: