Jacquemin, Rebecca A
Jacquemin, Rebecca A is an individual health care provider with primary practice located at 11971 James St , Holland MI 49424-9610. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Jacquemin, Rebecca A can be contacted via phone (616) 395-0606.Contact Information
Primary practice address
11971 James St
Holland MI 49424-9610
Phone: (616) 395-0606
Fax: (616) 395-0070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004404 | Michigan |
Profile Details
| NPI number | 1366508822 |
|---|---|
| LBN Legal business name | Jacquemin, Rebecca A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2006 |
| Last updated | Aug 16th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366508822 | NPPES |
| Michigan | Other | 204829649 | TAX ID |
| Michigan | MEDICAID | 5175716 | TAX ID |
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