MEDICARE: JENNIFER LANGILL KIKKERT MS, OTR/L

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
1	225XP0200X	Pediatric Occupational Therapist		MI

General Provider Information

NPI Number	:	1720936578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LANGILL KIKKERT MS, OTR/L

Provider Business Mailing Address
First Line	:	13434 GREENBRIAR DR
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-9161
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 S BEECHTREE ST
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2843
Country	:	US
Telephone Number	:	616-850-5140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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