Individual
JENIFER JOY VANWYNGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW, RN, DNP
Contact information
Practice address
1131 IONIA AVE NW, GRAND RAPIDS, MI 49503-1020
(616) 425-1585
Mailing address
1131 IONIA AVE NW, GRAND RAPIDS, MI 49503-1020
(616) 425-1585
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6802085599
MI
163W00000X
Registered Nurse
4704394880
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704394880
MI
Other
Enumeration date
02/15/2012
Last updated
02/27/2026
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