Individual
JEANNE M KAPENGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4129 OKEMOS RD STE 6, OKEMOS, MI 48864-2821
(616) 822-5509
Mailing address
3805 HEMMINGWAY DR, OKEMOS, MI 48864-3836
(616) 822-5509
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301406814
MI
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
4301406814
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4823348-10
—
MI
Enumeration date
05/27/2006
Last updated
01/29/2024
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