| Doctor Name: | JESSICA MEYERHOFF VANGESSEL |
| NPI Number: | 1245587021 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | 242888 |
| Business Practice Address: | 3380 44th St Sw Grandville, MI - 494182461 |
| Business Phone Number: | 6166858250 |
| Business Fax Number: | 6165323564 |
| Mailing Address: | 245 State St Se, Suite 1a GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495034328 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2012 |
| NPI Last Update Date: | 01/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 242888 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |