Provider Demographics
NPI:1053651968
Name:HESSELINK, LORI JEAN (RN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:JEAN
Last Name:HESSELINK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23563 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MI
Mailing Address - Zip Code:49665-8118
Mailing Address - Country:US
Mailing Address - Phone:231-775-3463
Mailing Address - Fax:231-775-1692
Practice Address - Street 1:23563 100TH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MI
Practice Address - Zip Code:49665-8118
Practice Address - Country:US
Practice Address - Phone:231-775-3463
Practice Address - Fax:231-775-1692
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704125008163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health