Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1043636707 |
---|---|
Provider Name | Ms. Teresa Jean Cramer |
First Address | Grand Rapids, MI 49505-5207 |
Second Address | Grand Rapids, MI 49505-5207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2014 |
Last Update Date | 09/09/2016 |