Basic Information
| Provider Information | |||||||||
| NPI: | 1245242056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUYPER | ||||||||
| FirstName: | JAMI | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 757 45TH STREET | ||||||||
| Address2: | STE. 201 | ||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2199225550 | ||||||||
| FaxNumber: | 2199225555 | ||||||||
| Practice Location | |||||||||
| Address1: | 9034 COLUMBIA AVENUE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198360296 | ||||||||
| FaxNumber: | 2198360570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 04/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 041207191 | IL | N | Nursing Service Providers | Registered Nurse | 163W00000X | 28112859A | IN | Y | Nursing Service Providers | Registered Nurse |
No ID Information.