Provider Demographics
NPI:1275905481
Name:GEERDES, BRITTANY MICHELE (NP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MICHELE
Last Name:GEERDES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:MICHELE
Other - Last Name:WOODALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3394 E JOLLY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-8594
Mailing Address - Country:US
Mailing Address - Phone:517-272-9700
Mailing Address - Fax:517-272-9706
Practice Address - Street 1:3271 CLEAR VISTA CT NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9477
Practice Address - Country:US
Practice Address - Phone:616-267-7293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704313080363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner