Provider Demographics
NPI:1336665769
Name:ADVANCED PRACTICE NURSE STAFFING ASSOCIATE, LLC
Entity Type:Organization
Organization Name:ADVANCED PRACTICE NURSE STAFFING ASSOCIATE, LLC
Other - Org Name:ADVANCED PRACTICE NURSE STAFFING ASSOCIATES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NP
Authorized Official - Phone:616-649-3776
Mailing Address - Street 1:4448 KOINONIA DR NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4448 KOINONIA DR NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9332
Practice Address - Country:US
Practice Address - Phone:616-649-3776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PRACTICE NURSE STAFFING ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-17
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty