Provider Demographics
NPI:1689823247
Name:VANDENENDE, NINA RAE (NP)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:RAE
Last Name:VANDENENDE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1401 PRESQUE ISLE AVENUE
Mailing Address - Street 2:HEALTH CENTER
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855
Mailing Address - Country:US
Mailing Address - Phone:906-227-2355
Mailing Address - Fax:906-227-2332
Practice Address - Street 1:1401 PRESQUE ISLE AVENUE
Practice Address - Street 2:HEALTH CENTER
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855
Practice Address - Country:US
Practice Address - Phone:906-227-2355
Practice Address - Fax:906-227-2332
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2023-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704220871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily