Ray, Jenna Lynn

Ray, Jenna Lynn is an individual health care provider with primary practice located at 3264 N Evergreen Dr Ne , Grand Rapids MI 49525-9746. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ray, Jenna Lynn can be contacted via phone (616) 363-7272.

Contact Information

Primary practice address
3264 N Evergreen Dr Ne Grand Rapids MI 49525-9746
Phone: (616) 363-7272
Fax: (616) 361-5828
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 010560-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601005457 Michigan

Profile Details

NPI number 1487627733
LBN Legal business name Ray, Jenna Lynn
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Dec 18th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487627733 NPPES
New York MEDICAID 02673554

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