Individual provider · Type 1 NPI
Samuel Terranova, NP
Primary Care Nurse Practitioner · Grand Rapids, MI
NPI number
1154201689
Active
Practice location
770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602
Fax (616) 259-4839
Mailing address
801 Rosehill Rd
Jackson, MI 49202-1762
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 4704356674 (MI) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1154201689
Samuel Terranova, NP's National Provider Identifier is 1154201689, issued on Sep 4, 2025. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Grand Rapids, MI. The record was last updated on Jan 20, 2026.