Individual
JENNIFER LYNNE DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7128 FULTON ST E, ADA, MI 49301-8413
(616) 825-3530
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704222326
MI
Other
Enumeration date
05/24/2006
Last updated
10/07/2022
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