Most Relevant Information
Provider Data
| NPI Number: | 1003575937 |
| Provider Name: | JESSICA ANNE YATES NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704291364 |
Most Important Dates
| Enumeration Date: | 12/08/2021 |
| Last Updated: | 03/09/2022 |
Provider Practice Location
2776 S STATE RD
IONIA
MI
488468472
Practice Location Phone/Fax
| Phone: | 6167757500 |
| Fax: |
Provider Mailing Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS
MI
495032560
Provider Mailing Phone/Fax
| Phone: | 6164866790 |
| Fax: |