Individual
JACKIE A BOUWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3097 PRAIRIE ST SW, GRANDVILLE, MI 49418-2000
(616) 531-9973
Mailing address
2901 BUTTERWORTH ST SW, WALKER, MI 49534-7042
(616) 550-5770
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704200879
MI
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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