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Individual

MICHELLE L. VANDENTOORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2531
(616) 267-7104
(616) 267-7594
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704278133
MI
363L00000X
Nurse Practitioner
4704278133
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704278133
MI
363LP2300X
Primary Care Nurse Practitioner
4704278133
MI
364SA2200X
Adult Health Clinical Nurse Specialist
4704278133
MI

Other

Enumeration date
06/29/2016
Last updated
12/09/2024
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