Darby Rae Disselkoen, DNP, APRN, CPNP-PC
Nurse Practitioner, Pediatrics in Zeeland, MI. Individual provider (NPI-1).
NPI number1316618382
StatusActive
Last updated in NPPESDec 13, 2021
Details
- NPI
- 1316618382
- Entity type
- Individual (NPI-1)
- Name
- Darby Rae Disselkoen
- Credential
- DNP, APRN, CPNP-PC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 21, 2021
- Certification date
- Dec 13, 2021
- Last updated
- Dec 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 4704320802 | MI | Yes |
Practice location
8333 Felch St Ste 200Zeeland, MI 49464-2609
Phone 616-748-2850
Mailing address
100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
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