Provider Demographics
NPI:1043290737
Name:JANDRON, CINDY (APN)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:JANDRON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:TOKARZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1543 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-5276
Mailing Address - Country:US
Mailing Address - Phone:231-798-7313
Mailing Address - Fax:
Practice Address - Street 1:165 E APPLE AVE
Practice Address - Street 2:SUITE # 201
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-3463
Practice Address - Country:US
Practice Address - Phone:231-725-4105
Practice Address - Fax:231-725-8196
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704137329363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4493565Medicaid
MIN33890005Medicare ID - Type Unspecified
MI4493565Medicaid