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Mr. Jack A Kooienga, APRN
Acute Care Nurse Practitioner in Wyoming, Michigan
NPI 1518216308

Jack A Kooienga is an Acute Care Nurse Practitioner based in Wyoming, MI and is specialized in Acute Care. Jack A Kooienga practices in Wyoming, MI and has the professional credentials of APRN. The NPI Number for Jack A Kooienga is 1518216308 and holds a License No. 4704218318 (Michigan).

The current practice location address for Jack A Kooienga is 5900 Byron Center Ave Sw, Wyoming, MI and can be reached out via phone at 616-252-7200 and via fax at 616-252-7830.

Location: 5900 Byron Center Ave Sw, Wyoming, MI, 49509-9563
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518216308
Provider Name
Jack A Kooienga
Credential
APRN
Provider Entity Type
Individual
Gender
Male
Address
5900 Byron Center Ave Sw, Wyoming, MI, 49509-9563
Phone Number
616-252-7200
Fax Number
616-252-7830
Provider Enumeration Date
09/07/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
110773300 05 FL
institution
Provider Business Practice Location Address Details
Address
5900 Byron Center Ave Sw
City
Wyoming
State
Michigan
Zip
49519-9606
Phone Number
616-252-7200
Fax Number
616-252-7830
person
Provider Business Mailing Address Details
Address
5900 Byron Center Ave Sw
City
Wyoming
State
Michigan
Zip
49519-9606
Phone Number
616-252-7200
Fax Number
616-252-7830
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Acute Care
Taxonomy
363LA2100X
License No.
APRN11012762 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Critical Care Medicine
Taxonomy
363LC0200X
License No.
4704218318 (Michigan)
Definition
Definition to come...
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