Vandyke, Judy K.

Vandyke, Judy K. is an individual health care provider with primary practice located at 1 Hurley Plz , Flint MI 48503-5902. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Vandyke, Judy K. can be contacted via phone (810) 262-9353.

Contact Information

Primary practice address
1 Hurley Plz Flint MI 48503-5902
Phone: (810) 262-9353
Fax: (810) 262-9187
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704133863 Michigan

Profile Details

NPI number 1750408688
LBN Legal business name Vandyke, Judy K.
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2007
Last updated Jun 28th, 2012 - about 13 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 1750408688 NPPES
Michigan Other 0B51149 BLUE SHIELD
Michigan MEDICAID 4130451 BLUE SHIELD

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