Individual
JAMIE LAUREN DEKORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 464-0279
(616) 301-1971
Mailing address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 464-0279
(616) 301-1971
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
4704222608
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704222608
NURSING LICENSE
MI
Enumeration date
10/30/2012
Last updated
10/30/2012
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