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Individual

JASON MECHENBIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6220 W MAIN ST STE B, KALAMAZOO, MI 49009-8925
(269) 276-4744
Mailing address
601 JOHN STREET, BOX 39, KALAMAZOO, MI 49007

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP-03548
NM
363LF0000X
Family Nurse Practitioner
Primary
4704371702
MI
363LF0000X
Family Nurse Practitioner
CNP-03548
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
54174741
NM
Enumeration date
04/23/2018
Last updated
06/16/2021
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