MEDICARE: TANIA DEE VANDYKE N.P.

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	163W00000X	Registered Nurse	4704145235	MI
2	363LG0600X	Gerontology Nurse Practitioner	4704145235	MI

General Provider Information

NPI Number	:	1790783926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA DEE VANDYKE N.P.

Provider Business Mailing Address
First Line	:	1310 WISCONSIN ST STE 101
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2472
Country	:	US
Telephone Number	:	616-296-1550
Fax Number	:	616-296-6155

Provider Business Practice Location Address
First Line	:	1310 WISCONSIN ST STE 301
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-2472
Country	:	US
Telephone Number	:	616-296-1550
Fax Number	:	616-296-1554

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	01/04/2022

Similar Medicare Providers

1770587008 — EDWARD A HATT MD
Practice Location Address:

1310 WISCONSIN ST STE 100
GRAND HAVEN, MI
49417-2472

Practice Phone: 616-296-1600
Practice Fax: 616-296-1602

1134121270 — LARRY A POEL D.O.
Practice Location Address:

1310 WISCONSIN AVE , SUITE 301
GRAND HAVEN, MI
49417-2472

Practice Phone: 616-847-1860
Practice Fax: 616-844-4670

1356345698 — RAYMOND P RABIDEAU D.O.
Practice Location Address:

1310 WISCONSIN AVE , SUITE 301
GRAND HAVEN, MI
49417-2472

Practice Phone: 616-847-1860
Practice Fax: 616-844-4537

1467457143 — PATRICIA MARIA DEVRIES NP
Practice Location Address:

1310 WISCONSIN ST STE 100
GRAND HAVEN, MI
49417-2472

Practice Phone: 616-296-1600
Practice Fax: 616-296-1604

1780677393 — DR. NORMAN RUSSELL BOEVE M.D.
Practice Location Address:

1310 WISCONSIN AVE
GRAND HAVEN, MI
49417-2472

Practice Phone: 616-846-4530
Practice Fax: 616-846-9271

1891752168 — MARILENA C ORAVITAN MD
Practice Location Address:

1310 WISCONSIN ST , SUITE 100
GRAND HAVEN, MI
49417-2472

Practice Phone: 616-844-4701
Practice Fax: 616-847-1863

Directions to “ TANIA DEE VANDYKE N.P.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.