Provider Demographics
NPI:1942907522
Name:WOLTERINK, JANE KATHRYN
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:KATHRYN
Last Name:WOLTERINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-2734
Mailing Address - Country:US
Mailing Address - Phone:616-566-3064
Mailing Address - Fax:
Practice Address - Street 1:333 MICHIGAN ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-3300
Practice Address - Country:US
Practice Address - Phone:616-331-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program