Individual
ANDREA JO VANDERJAGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 855-5221
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704339525
MI
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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