Individual provider Active NPI

Lynn Elise Vandyke, RNFA

  • Registered Nurse First Assistant
  • Grand Haven, MI
National Provider Identifier
1508300468
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
4704230898 Issued in MI
Practice address
1445 Sheldon Rd Ste G1
Grand Haven, MI 49417-2479
Phone
(616) 296-9100
NPI assigned
Dec 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 4704230898 MI Primary

Addresses

Primary practice location

1445 Sheldon Rd Ste G1
Grand Haven, MI 49417-2479

Mailing address

1420 Hillcrest St
Grand Haven, MI 49417-2443
Phone (616) 296-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704230898MIMDRegistered Nurse First Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1508300468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 HILLCREST ST",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172443",
            "telephone_number": "616-296-9100",
            "fax_number": "616-296-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SHELDON RD STE G1",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172479",
            "telephone_number": "616-296-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "LYNN",
        "middle_name": "ELISE",
        "credential": "RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MI",
            "license": "4704230898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.