Provider Demographics
NPI:1174573687
Name:HOEKSTRA, DEBRA J (LPN)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:J
Last Name:HOEKSTRA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 SNOW AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALTO
Mailing Address - State:MI
Mailing Address - Zip Code:49302-9398
Mailing Address - Country:US
Mailing Address - Phone:616-868-0769
Mailing Address - Fax:
Practice Address - Street 1:6226 SNOW AVE SE
Practice Address - Street 2:
Practice Address - City:ALTO
Practice Address - State:MI
Practice Address - Zip Code:49302-9398
Practice Address - Country:US
Practice Address - Phone:616-868-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703096180164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse