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General NPI Number Information
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NPI Number | 1326920703
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Entity Type | Individual
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Provider Name | BRIANNA VANHOUTEN
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Gender | Female
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 15400 WALDRON WAY
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City | BIG RAPIDS
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State | MI
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Zip | 49307-8890
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Country | US
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Telephone | 231-527-0210
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Fax |
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Provider Business Mailing Address
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Address Line | 5659 S DICKERSON RD
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City | LAKE CITY
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State | MI
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Zip | 49651-9026
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302417615
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License Number State | MI
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