Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eric Randall Dejong, AGACNP

Individual provider Gerontology Nurse Practitioner · NPI 1629619903

Eric Randall Dejong, AGACNP is a Nurse Practitioner in Holland, Michigan. Graduated from Georgetown University School of Medicine in 2019, 7 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Trained at
Georgetown University School of Medicine
Licensed in
MI
In the registry since
2019

Practice location Address checks out

602 Michigan Ave Ste 102
Holland, MI 49423-4918
Phone: (616) 494-8724
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 4704295254 (MI)

Record details

NPI number1629619903
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedOctober 8, 2019
Last updated in NPPESOctober 14, 2022
Certification dateOctober 14, 2022
Mailing address100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Holland