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Individual

JANE HANNEKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-6500
Mailing address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301044447
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0803910201
BCBS
05
4183384
MI
Enumeration date
03/14/2006
Last updated
05/24/2012
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