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:
Health care specialties
| Specialty | Code | License # | 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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