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NPI Code Detail

MEDICARE: EVELYN ROSE FEHRLEN

MEDICARE: EVELYN ROSE FEHRLEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1417832593
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN ROSE FEHRLEN
Provider Business Mailing Address
First Line : 1318 SIBLEY ST NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-5463
Country : US
Telephone Number : 616-350-4610
Fax Number :
Provider Business Practice Location Address
First Line : 108 N LAFAYETTE ST STE D
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-1883
Country : US
Telephone Number : 616-255-9780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2025
Last Update Date : 08/08/2025

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Directions to “ EVELYN ROSE FEHRLEN ” Practice Location

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