Healthcare Provider Details

I. General information

NPI: 1225946262
Provider Name (Legal Business Name): TAYLOR BRUINSMA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12330 JAMES ST STE H10
HOLLAND MI
49424-9575
US

IV. Provider business mailing address

12330 JAMES ST STE H10
HOLLAND MI
49424-9575
US

V. Phone/Fax

Practice location:
  • Phone: 616-582-3100
  • Fax:
Mailing address:
  • Phone: 616-582-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704342183
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: