MRS. JENNIFER J. KOETJE (NPI# 1912908997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912908997 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER J. KOETJE |
| Credential | PA |
| Practice Address |
905 E Colby St Whitehall MI 49461-1262 |
| Mailing Address |
Po Box 1848 Muskegon MI 49443-1848 |
| Practice Telephone | 2317285910 |
| Practice Fax Number | 2317285918 |
| Mailing Telephone | 2317275211 |
| Mailing Fax Number | 2317274571 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2017-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601002222 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
905 E COLBY ST |
| City | WHITEHALL |
| State | MI |
| Zip Code | 49461-1262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801208087 | Mercy Health Partners | Surgery | 905 E Colby St, Whitehall, MI 49461-1262 | 2014-05-22 |
| 1861818379 | Mercy Health Partners | Clinic/Center | 905 E Colby St, Whitehall, MI 49461-1262 | 2014-03-07 |
| 1326463357 | Mercy Health Partners | Clinic/Center | 905 E Colby St, Whitehall, MI 49461-1262 | 2014-02-27 |
| 1932403037 | Desiree Lee Elliot | Physician Assistant | 905 E Colby St, Whitehall, MI 49461-1262 | 2011-01-04 |
| 1336385996 | Lakeshore Community Hospital, Inc. | Family Medicine | 905 E Colby St, Whitehall, MI 49461-1262 | 2008-12-31 |
| 1629214739 | Lakeshore Community Hospital, Inc. | Clinic/Center | 905 E Colby St, Whitehall, MI 49461-1262 | 2008-12-18 |
| 1619128873 | Lakeshore Community Hospital, Inc. | Clinic/Center | 905 E Colby St, Whitehall, MI 49461-1262 | 2008-10-07 |
| 1992997647 | Matthew John Roberge | Family Medicine | 905 E Colby St, Whitehall, MI 49461 | 2007-08-16 |
| 1346455888 | Hpcn | Family Medicine | 905 E Colby St, Whitehall, MI 49461-1262 | 2007-05-10 |
| 1578602520 | Hackley Professional Pharmacy | Pharmacy | 905 E Colby St, Whitehall, MI 49461-1262 | 2007-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1720367055 | Jacob Marshall Taylor | Family Medicine | 905 E Colby St Ste 100, Whitehall, MI 49461 | 2011-08-04 |
| 1700982865 | Brent Richard Beacom | Chiropractor | 923 Colby Rd, Whitehall, MI 49461 | 2006-09-16 |
| 1760592539 | Preston Teval Bown | Dentist | 504 E Colby St, Whitchall, MI 49461 | 2006-08-30 |
| 1801821301 | Helena Maria Beacom | Chiropractor | 923 E Colby Rd, Beacom Family Chiropractic, Whitehall, MI 49461 | 2006-07-12 |
| 1710013040 | Ronald A Lehman | Dentist | 116 W Colby St, Suite 1, Whitehall, MI 49461 | 2007-02-23 |
| 1073619136 | Beacom Family Chiropractic Wellness | Chiropractor | 923 Colby Rd, Whitehall, MI 49461 | 2006-09-16 |
| 1649388000 | Pitkin Rexall Drug Company | Pharmacy | 101 W Colby St, Whitehall, MI 49461-1014 | 2006-08-27 |
| 1689690125 | Hackley Hospital | Clinic/Center | 117 W Colby St, Whitehall, MI 49461-1014 | 2006-07-15 |
| 1619344363 | Christie Phillips | Pharmacy Technician | 101 W Colby St, Whitehall, MI 49461-1014 | 2015-08-28 |
| Find all providers in zip 49461 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
| 1366446841 | Douglas B Moericke | Physician Assistant | 18601 Lincoln St, Whitehall, WI 54773-8605 | 2005-06-13 |
| 1346807294 | Caitlin Marie Luttropp | Physician Assistant | 18601 Lincoln St, Whitehall, WI 54773-8605 | 2019-05-28 |
| 1851801617 | Shirley Wong | Physician Assistant | 1401 Fairmont St, Whitehall, PA 18052-6015 | 2017-10-06 |
| 1265762850 | Jessica Kt Knauss | Physician Assistant | 1401 Fairmont St, Whitehall, PA 18052-6015 | 2010-01-05 |
| 1518182179 | Anthony F Friendy | Physician Assistant | 3691 Crescent Ct E, Whitehall, PA 18052-3498 | 2007-04-17 |
| 1295774412 | John James Archambeault | Physician Assistant | 905 E Colby St, Whitehall, MI 49461-1262 | 2006-06-05 |
| 1821037268 | Matthew Allen Tripp | Physician Assistant | 905 E Colby St, Whitehall, MI 49461 | 2006-06-04 |
| 1396741823 | Angela E House | Physician Assistant | 18601 Lincoln St, Whitehall, WI 54773 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.