Individual
JENNIFER JACOBUSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 PRAIRIE ST SW, GRANDVILLE, MI 49418-2047
(616) 531-9973
Mailing address
1121 N VISTA LN, ALLEGAN, MI 49010-8105
(616) 446-1566
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704239938
MI
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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