Individual
JENNIFER LYNNE KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2221 HEALTH DRIVE SW, SUITE 2100, WYOMING, MI 49519-9606
(616) 252-4410
(616) 252-4480
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004257
MI
363A00000X
Physician Assistant
6324
GA
Other
Enumeration date
12/20/2006
Last updated
03/04/2022
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