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NPI Code Detail

MEDICARE: JOAN M VANSOLKEMA MSN

MEDICARE: JOAN M VANSOLKEMA MSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse4704085069MI
2363L00000XNurse Practitioner4704085069MI

General Provider Information

NPI Number : 1669451027
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN M VANSOLKEMA MSN
Provider Business Mailing Address
First Line : PO BOX 1969
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49501-1969
Country : US
Telephone Number : 616-532-8000
Fax Number : 616-532-7230
Provider Business Practice Location Address
First Line : 1055 MEDICAL PARK DR SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-3607
Country : US
Telephone Number : 800-968-6866
Fax Number : 616-532-7230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 06/11/2010

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