Individual provider · Type 1 NPI
Tracy Dejonge
Pediatric Registered Nurse · Plymouth, MI
NPI number
1487569000
Active
Practice location
671 N Evergreen St
Plymouth, MI 48170-1176
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Registered Nurse Primary | 163WP0200X | 4704349092 (MI) |
Pediatric Registered Nurse: Definition to come...
About NPI 1487569000
Tracy Dejonge's National Provider Identifier is 1487569000, issued on Aug 18, 2026. The primary taxonomy on file is Pediatric Registered Nurse (163WP0200X), and the practice location is in Plymouth, MI. The record was last updated on Aug 18, 2026.