Healthcare Provider Details

I. General information

NPI: 1952462913
Provider Name (Legal Business Name): RHONDA ANN DEYOUNG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHONDA ANN VOLKERS NP

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 MICHIGAN ST NE SPECTRUM HEALTH HOSPITAL
GRAND RAPIDS MI
49503-2562
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC 845
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-486-6800
  • Fax: 616-486-6345
Mailing address:
  • Phone: 616-486-6800
  • Fax: 616-486-6345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704232909
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: