Individual
JENNIFER RAE VANLOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
107 N BRIDGE ST, SARANAC, MI 48881-5121
(616) 642-9408
(616) 642-6940
Mailing address
8744 MUSGROVE HWY, SUNFIELD, MI 48890-9797
(206) 595-5001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704254772
MI
363L00000X
Nurse Practitioner
4704254772
MI
363LF0000X
Family Nurse Practitioner
Primary
4704254772
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715928
—
MI
Enumeration date
11/14/2006
Last updated
10/31/2023
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