Most Relevant Information
Provider Data
| NPI Number: | 1003365396 |
| Provider Name: | JUSTINE MELODIE OUDSEMA PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 5601007970 |
Most Important Dates
| Enumeration Date: | 09/27/2016 |
| Last Updated: | 04/25/2024 |
Provider Practice Location
601 JOHN ST
BOX 74
KALAMAZOO
MI
490075341
Practice Location Phone/Fax
| Phone: | 2693418481 |
| Fax: | 2693417781 |
Provider Mailing Location
601 JOHN ST
BOX 74
KALAMAZOO
MI
490075341
Provider Mailing Phone/Fax
| Phone: | 2693418481 |
| Fax: | 2693417781 |