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1174060537
JASON FENNEMA
GRAND RAPIDS, MI
NPI
1174060537
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: MI 4704279909)
Enumeration Date
2017-01-24
Last Update Date
2024-01-26
Business Address
JASON FENNEMA CRNA
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503-4502
Phone number: 616-391-1609
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Mailing Address
JASON FENNEMA CRNA
13348 HIDDEN CREEK DR
GRAND HAVEN, MI 49417-8964
Phone number:
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