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General NPI Number Information
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NPI Number | 1407769904
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Entity Type | Individual
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Provider Name | PAULA KRZOS
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Gender |
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 275 MICHIGAN ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2531
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Country | US
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Telephone | 616-391-5055
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Fax |
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Provider Business Mailing Address
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Address Line | 3336 SNAKE RIVER ST SW
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City | WYOMING
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State | MI
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Zip | 49418-8816
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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 | 1835S0206X
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Taxonomy Name | Solid Organ Transplant Pharmacist
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License Number | 5302415290
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License Number State | MI
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