Individual
JESSICA LEE VANDER MOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-2888
(574) 364-2590
Mailing address
PO BOX 834, GOSHEN, IN 46527-0834
(574) 364-2592
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71016764A
IN
Other
Enumeration date
06/05/2025
Last updated
05/05/2026
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