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Dr. Elizabeth Renee Prentice, D.O.

Pediatrics in Grand Rapids, MI. Individual provider (NPI-1).

NPI number1396946331
StatusActive
Last updated in NPPESJun 4, 2025

Details

NPI
1396946331
Entity type
Individual (NPI-1)
Name
Dr. Elizabeth Renee Prentice
Credential
D.O.
Sex
Female
Sole proprietor
No
Enumeration date
May 29, 2007
Certification date
Jun 4, 2025
Last updated
Jun 4, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208000000X Pediatrics5101016800MIYes
2080P0203X Pediatrics, Pediatric Critical Care Medicine5101016800MI

Practice location

100 Michigan St Ne
Grand Rapids, MI 49503-2560

Phone 616-267-0118 · Fax 616-267-0090

Mailing address

100 Michigan St Ne
Mc 845
Grand Rapids, MI 49503-2560

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