Individual provider · Type 1 NPI

Jacie Leann Lutke

Student in an Organized Health Care Education/Training Program · Grand Rapids, MI

NPI number 1114508371 Active

Practice location

3300 36th St SE
Grand Rapids, MI 49512-2810

Call (231) 429-2228 Map

Mailing address

10999 Stegman Forest Ct NE
Rockford, MI 49341-7642

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1114508371

Jacie Leann Lutke's National Provider Identifier is 1114508371, issued on Apr 19, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Grand Rapids, MI. The record was last updated on Apr 19, 2021.