Individual
JENNIFER ELIZABETH MELLEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
212 S SULLIVAN AVE, FREMONT, MI 49412-1548
(616) 391-3139
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
4704246219
MI
Other
Enumeration date
01/29/2024
Last updated
09/09/2024
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