Healthcare Provider Details
I. General information
NPI: 1952852352
Provider Name (Legal Business Name): JENNIFER KURINSKY ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
638 FULTON ST W SUITE B
GRAND RAPIDS MI
49504-6313
US
IV. Provider business mailing address
638 FULTON ST W SUITE B
GRAND RAPIDS MI
49504-6313
US
V. Phone/Fax
- Phone: 616-264-6556
- Fax: 616-432-3561
- Phone: 616-264-6556
- Fax: 616-432-3561
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | 16-1586 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: