Provider Demographics
NPI:1518243278
Name:HALIGOWSKI, EMILY SUZANNE (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SUZANNE
Last Name:HALIGOWSKI
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:1900 WEALTHY ST SE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-2969
Mailing Address - Country:US
Mailing Address - Phone:616-459-3158
Mailing Address - Fax:616-988-0071
Practice Address - Street 1:2093 HEALTH DR SW
Practice Address - Street 2:SUITE 200
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9691
Practice Address - Country:US
Practice Address - Phone:616-459-3158
Practice Address - Fax:616-988-2222
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2016-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704249269363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D16122040Medicare PIN