Individual
JENNIFER D LOXTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
100 MICHIGAN ST NE, MC 059, GRAND RAPIDS, MI 49503-2560
(616) 391-1870
Mailing address
100 MICHIGAN ST NE, MC 059, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N64030003
MEDICARE
MI
Enumeration date
07/14/2008
Last updated
07/14/2008
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