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GERALDINE MARIE JACK BS, ETS
NPI 1649574021
Specialist in Grand Rapids, MI

Active since December 29, 2010
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506(616) 450-6482 Get Directions Write a Review

NPPES record last updated: August 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Geraldine Marie Jack Bs, Ets NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GERALDINE MARIE JACK BS, ETS (NPI 1649574021) is an individual specialist in Grand Rapids, Michigan, licensed in Michigan (000000) and active in the NPI registry since December 2010.

NPPES Registry Identity

NPI1649574021
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameGERALDINE MARIE JACKCredential: BS, ETS
Location Address1490 E BELTLINE AVE SEGrand Rapids, MI 49506-4336
Mailing Address1490 E Beltline Ave SeGrand Rapids, MI 49506-4336 · (616) 450-6482
Phone(616) 450-6482
Sole ProprietorNo
Enumeration DateDecember 29, 2010
Last NPPES UpdateAugust 23, 2021
NPPES CertifiedAugust 23, 2021
✔ NPI 1649574021 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MI · 000000
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1490 E BELTLINE AVE SE, Grand Rapids, MI 49506
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICHARD KEITH SMEDLEY RMA
Technician (Personal Care Attendant)
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (616) 940-0040
SAMANTHA KAY RASTALL
Behavior Technician
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (616) 248-5205
JENNIFER JOHNSON
Technician (Personal Care Attendant)
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (000) 000-0000
MRS. KWANYAH SEAWOOD SANDIFER
Licensed Practical Nurse
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (616) 940-0040
DEVAN ALEXIS COURTLAND
Technician (Personal Care Attendant)
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (855) 407-7575
JULIE DALTON
Rehabilitation Practitioner
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (616) 940-0040
BRITTENY JEAN ALDRICH
Technician (Personal Care Attendant)
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (616) 788-5955
DANIELLE SUZANNE DETTMANN
Technician (Personal Care Attendant)
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506
Kent County (269) 804-2828

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Geraldine Jack's NPI number?

The NPI number for Geraldine Jack is 1649574021. It was assigned to this individual provider in the NPPES registry on December 29, 2010.

Where is Geraldine Jack located?

Geraldine Jack practices at 1490 E Beltline Ave SE, Grand Rapids, MI 49506. The listed phone number is (616) 450-6482.

What is Geraldine Jack's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Geraldine Jack was last updated on August 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.