Provider Demographics
NPI:1669544078
Name:PAAUWE, JILL A (NP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:A
Last Name:PAAUWE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:A
Other - Last Name:HOLQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4500 BRETON RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5290
Mailing Address - Country:US
Mailing Address - Phone:616-391-4200
Mailing Address - Fax:616-391-4230
Practice Address - Street 1:100 MICHIGAN ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2560
Practice Address - Country:US
Practice Address - Phone:616-391-4200
Practice Address - Fax:616-391-4230
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704190926363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology