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General NPI Number Information
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NPI Number | 1841036548
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Entity Type | Individual
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Provider Name | ANNE C VERMEULEN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 100 CHERRY ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4526
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Country | US
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Telephone | 616-965-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 6240 BLENDON DR APT 302
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City | HUDSONVILLE
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State | MI
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Zip | 49426-8042
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Country | US
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Telephone | 407-718-1746
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704314459
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License Number State | MI
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