Individual
KRISTIN VANDERWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6050 NORTHLAND DR NE STE 200, ROCKFORD, MI 49341
(616) 685-8350
(616) 363-8870
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704292621
MI
Other
Enumeration date
01/15/2016
Last updated
09/20/2018
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