Individual
MR. JARED JENNINGS POPPEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
440 BALTIMORE DR NE, GRAND RAPIDS, MI 49503-3934
(616) 301-8000
Mailing address
456 BALTIMORE DR NE, GRAND RAPIDS, MI 49503-3934
(616) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704328954
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704328954
RN LICENSE NUMBER
MI
Enumeration date
01/23/2020
Last updated
03/07/2023
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