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Autumn Shoup
NPI 1508729054 · on the registry since 2025 · sole proprietor
Practice
- Address
- 551 36th St Se
Grand Rapids, MI 49548 - Phone
- (844) 854-1116
- Clinicians at this address
- 112
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-12-11
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan