Individual
MR. DOMENIQUE TAMMINGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
1743 STATE ST, HOLLAND, MI 49424-6228
(616) 834-1417
Mailing address
1743 STATE ST, HOLLAND, MI 49424-6228
(616) 834-1417
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704308086
MI
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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