Most Relevant Information
Provider Data
| NPI Number: | 1003342551 |
| Provider Name: | KATHERINE PRUSS DNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704274169 |
Most Important Dates
| Enumeration Date: | 05/03/2017 |
| Last Updated: | 05/03/2017 |
Provider Practice Location
3201 BURTON ST SE
SB 260
GRAND RAPIDS
MI
495464301
Practice Location Phone/Fax
| Phone: | 6165266808 |
| Fax: |
Provider Mailing Location
3411 BURTON RIDGE RD SE
APT B
GRAND RAPIDS
MI
495465834
Provider Mailing Phone/Fax
| Phone: | 7342234562 |
| Fax: |