Amy Boekeloo, CRNA
Nurse Anesthetist, Certified Registered in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1255893137
StatusActive
Last updated in NPPESMay 5, 2019
Details
- NPI
- 1255893137
- Entity type
- Individual (NPI-1)
- Name
- Amy Boekeloo
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 1, 2019
- Last updated
- May 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 4704286489 | MI | Yes |
| 163W00000X | Registered Nurse | 4704286489 | MI |
Practice location
200 Jefferson Ave SeGrand Rapids, MI 49503-4502
Phone 616-685-5000
Mailing address
1322 Madrid Dr SwByron Center, MI 49315-7989
Phone 269-552-8351
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