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NPI Code Detail

MEDICARE: MRS. MARGERY LORRAINE RITZEMA-BEHR RN

MEDICARE: MRS. MARGERY LORRAINE RITZEMA-BEHR RN
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
1163W00000XRegistered Nurse4704205201MI

General Provider Information

NPI Number : 1962530642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARGERY LORRAINE RITZEMA-BEHR RN
Provider Business Mailing Address
First Line : 1256 WALKER AVE NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-4067
Country : US
Telephone Number : 616-235-2910
Fax Number : 616-235-2066
Provider Business Practice Location Address
First Line : 1256 WALKER AVE NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-4067
Country : US
Telephone Number : 616-235-2910
Fax Number : 616-235-2066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/08/2007

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