Individual
MS. JUDY K. VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1 HURLEY PLZ, FLINT, MI 48503-5902
(810) 262-9353
(810) 262-9187
Mailing address
1 HURLEY PLZ, 5TH FLOOR S.O.N., FLINT, MI 48503-5902
(810) 762-7038
(810) 760-0440
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704133863
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51149
BLUE SHIELD
MI
05
—
4130451
—
MI
Enumeration date
03/24/2007
Last updated
06/28/2012
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