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Individual

MS. JAYNE DEUR PETTINGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
3200 KNIGHT WAY SE, CALVIN COLLEGE HEALTH SERVICES, GRAND RAPIDS, MI 49546-4407
(616) 526-6187
(616) 526-6548
Mailing address
3200 KNIGHT WAY SE, CALVIN COLLEGE HEALTH SERVICES, GRAND RAPIDS, MI 49546-4407
(616) 526-6187
(616) 526-6548

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704119236
MI

Other

Enumeration date
06/30/2008
Last updated
06/30/2008
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