Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704244368 | MI |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 041.359773 | IL |
NPI | 1013117209 |
---|---|
Provider Name | Danielle Allman |
First Address | Grand Rapids, MI 49525-9746 |
Second Address | Kalamazoo, MI 49007-5341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 29/11/2018 |