Individual
MRS. JENNIFER ANN GOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1000 E PARIS AVE SE STE 200, GRAND RAPIDS, MI 49546-8383
(616) 685-3450
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704225398
MI
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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