Provider Demographics
NPI:1750141891
Name:GULLIVER, STEPHANIE
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:GULLIVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 VIEWPOINT DR NE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49306-9483
Mailing Address - Country:US
Mailing Address - Phone:616-240-1097
Mailing Address - Fax:
Practice Address - Street 1:6160 VIEWPOINT DR NE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MI
Practice Address - Zip Code:49306-9483
Practice Address - Country:US
Practice Address - Phone:616-240-1097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula