Provider Demographics
NPI:1952462913
Name:DEYOUNG, RHONDA ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ANN
Last Name:DEYOUNG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:RHONDA
Other - Middle Name:ANN
Other - Last Name:VOLKERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC 845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6800
Mailing Address - Fax:616-486-6345
Practice Address - Street 1:145 MICHIGAN ST NE
Practice Address - Street 2:SPECTRUM HEALTH HOSPITAL
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2562
Practice Address - Country:US
Practice Address - Phone:616-486-6800
Practice Address - Fax:616-486-6345
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232909363L00000X
IL209006707363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704232909OtherSTATE MEDICAL LICENSE