Mary Koenen is a Family in Grand Rapids, Michigan. Mary Koenen practices all healthcare services and medical treatments related to Family. The NPI Number for Mary Koenen is 1184777682. The last update date is 2007-07-08.
Mary Koenen's current location address is 72 Sheldon Blvd Se, Grand Rapids, Michigan. You can contact this provider via phone number 6169888774 and fax number 6169888775. The mailing address for Mary Koenen is 72 Sheldon Blvd Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Koenen |
|---|---|
| Address | 72 Sheldon Blvd Se, Grand Rapids, Michigan |
| Phone Number | 6169888774 |
| Fax Number | 6169888775 |
| Sole Proprietor | N |
| Credentials | F.N.P. |
NPI Number Detail
| NPI Number | 1184777682 |
|---|---|
| Provider Enumeration Date | 2007-01-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 72 Sheldon Blvd Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495034234 |
| Phone Number | 6169888774 |
| Fax Number | 6169888775 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | MK4704154566 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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What is the unique 10-digit identification code issued to Mary Koenen by the Centers for Medicare & Medicaid Services?
The Mary Koenen has been assigned the NPI (National Provider Identifier) 1184777682 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Mary Koenen's facilities are situated?
The facilities of Mary Koenen are physically located at the following address: 72 Sheldon Blvd Se, Grand Rapids, MI, 495034234.
What is the Mary Koenen's specialty and taxonomy code?
The Mary Koenen's specialty is Family, and the corresponding taxonomy code is 363Lf0000X.
On what date did Mary Koenen receive its 1184777682 assignment from the Centers for Medicare & Medicaid Services?
The Mary Koenen was assigned its 1184777682 on 2007-01-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Mary Koenen's details last updated?
The information pertaining to the Mary Koenen, including its address, specialty, and other details, was most recently updated on 2007-07-08.