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

Lara Dengerink-Vantil, NP

Individual provider Gerontology Nurse Practitioner · NPI 1679023501

Lara Dengerink-Vantil, NP is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with Spectrum Health Hospitals, a 165-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2016
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526
Phone: (616) 391-3777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 4704302218 (MI)

Record details

NPI number1679023501
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 4, 2016
Last updated in NPPESOctober 28, 2024
Certification dateOctober 28, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Spectrum Health Hospitals — 165 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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