Individual
JESSICA LYNN ROOSSIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
15151 STANTON ST STE A, WEST OLIVE, MI 49460-8544
(616) 296-1020
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(866) 611-1512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704288356
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704288356
LICENSE
MI
Enumeration date
03/10/2019
Last updated
12/30/2021
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