Individual
JEAN F KOOPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-2242
Mailing address
100 MICHIGAN ST NE, MC 845ATTN JULIE L, GRAND RAPIDS, MI 49503-2560
(616) 486-6772
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704208803
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558407189
GROUP NPI
MI
05
—
4663905
—
MI
01
—
5008704110
BCBS PIN
MI
Enumeration date
07/19/2006
Last updated
10/06/2009
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