Healthcare Provider Details

I. General information

NPI: 1376478537
Provider Name (Legal Business Name): CAILYN ROSE TENHOEVE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 BUTTERNUT DR
HOLLAND MI
49424-1503
US

IV. Provider business mailing address

735 PRESERVE CIRCLE DR SE APT 11
GRAND RAPIDS MI
49548-6962
US

V. Phone/Fax

Practice location:
  • Phone: 800-848-5991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704329885
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: