Provider Demographics
NPI:1386699692
Name:PALS, JENNIFER LEA (NP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEA
Last Name:PALS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LEA
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:616-486-6702
Practice Address - Street 1:1900 WEALTHY ST SE STE 200
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2969
Practice Address - Country:US
Practice Address - Phone:616-774-0276
Practice Address - Fax:616-774-5401
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704205211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily