Wiersum, Kevin J

Wiersum, Kevin J is an individual health care provider with primary practice located at 1111 Leffingwell Ave Ne Ste 100, Grand Rapids MI 49525-6406. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Wiersum, Kevin J can be contacted via phone (616) 459-7101.

Contact Information

Primary practice address
1111 Leffingwell Ave Ne Ste 100 Grand Rapids MI 49525-6406
Phone: (616) 459-7101
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 5601004099 Michigan

Profile Details

NPI number 1699762765
LBN Legal business name Wiersum, Kevin J
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Sep 18th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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