Provider Demographics
NPI:1568206472
Name:VANROOYEN, JOHANNES J SR (RN)
Entity type:Individual
Prefix:MR
First Name:JOHANNES
Middle Name:J
Last Name:VANROOYEN
Suffix:SR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 W STUART RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-1204
Mailing Address - Country:US
Mailing Address - Phone:360-982-1482
Mailing Address - Fax:
Practice Address - Street 1:459 W STUART RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-1204
Practice Address - Country:US
Practice Address - Phone:360-982-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60776002163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management