Individual provider · Type 1 NPI

Jacob Warren Kooistra Devries

Student in an Organized Health Care Education/Training Program · Bloomington, IN

NPI number 1811658131 Active

Practice location

701 E 17th St
Bloomington, IN 47408-1578

Call (812) 856-4465 Map

Mailing address

4425 Hickory Grove Blvd
Greenwood, IN 46143-7445

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.

10 other providers at this address

Other student in an organized health care education/training program providers in Bloomington

See all in Bloomington →

About NPI 1811658131

Jacob Warren Kooistra Devries's National Provider Identifier is 1811658131, issued on Jan 8, 2022. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Bloomington, IN. The record was last updated on Jan 8, 2022.