Individual
JANE VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
300 LAFAYETTE AVE SE, SUITE 4200, GRAND RAPIDS, MI 49503-4650
(616) 685-6922
(616) 685-5105
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704178469
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4425879
—
MI
05
—
4925197
—
MI
Enumeration date
05/26/2006
Last updated
06/30/2009
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