Provider Demographics
NPI:1750419297
Name:VAN SOELEN, MICHELE L (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:VAN SOELEN
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Gender:
Credentials:NP
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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:
Mailing Address - Fax:
Practice Address - Street 1:35 MICHIGAN ST NE FL 2
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2514
Practice Address - Country:US
Practice Address - Phone:616-267-1925
Practice Address - Fax:616-267-1005
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2025-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704174065363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI381360529OtherTAX ID