PAMELA VANDUSEN NP NPI 1700832995

NPI Information

  • NPI: 1700832995
  • Provider Name: PAMELA VANDUSEN, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 JEFFERSON SE
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 685-1835

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NPI Details

Pamela Vandusen, NP is a family nurse practitioner in Grand Rapids, MI. Pamela Vandusen, NP NPI is 1700832995. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 JEFFERSON SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 685-1835
Fax: (616) 685-1846

The NPI 1700832995 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 4/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily4704165365MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1M53750085MEDICARE PINMICHIGAN
21700832995MEDICAIDMICHIGAN
3MI3233393MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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