Individual
MS. CAROL ANN VANANTWERP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
5629 STADIUM DR, KALAMAZOO, MI 49009-1952
(269) 372-1000
(269) 372-0698
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704078169
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043408172
—
MI
01
—
500C912770
BCBS
MI
Enumeration date
10/15/2007
Last updated
09/23/2008
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