Individual
VANESSA J JESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CIBD FSID
Contact information
Practice address
N15285 EAGLE RD, WILSON, MI 49896-9622
(906) 250-6429
Mailing address
N15285 EAGLE RD, WILSON, MI 49896-9622
(906) 250-6429
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053146498
—
MI
01
—
229993
UPHP
MI
Enumeration date
09/05/2024
Last updated
10/12/2024
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