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General NPI Number Information
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NPI Number | 1811437817
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Entity Type | Organization
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Legal Business Name | EMBREE EMBRACING QUALITY CARE 'AT YOUR FRONT DOOR'
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 1735 WOODWARD AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4531
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Country | US
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Telephone | 616-540-8255
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 WOODWARD AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506
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Country | US
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Telephone | 616-540-8255
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. ANGELA L EMBREE
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Credential | AGPCNP-C
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Telephone | 616-540-8255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704267596
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License Number State | MI
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