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

MS. Elizabeth Ann Otter, PA-C

Individual provider Medical Physician Assistant · NPI 1639108293

MS. Elizabeth Ann Otter, PA-C is a Physician Assistant in Holland, Michigan. Qualified in 2005, 21 years ago. Practices with Jack a Dekkinga MD PC, a 20-clinician group and accepts Medicare assignment. Licensed in Michigan and Tennessee.

Years since qualifying
21
Licensed in
MI, TN
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

3290 N Wellness Dr Ste 240
Holland, MI 49424-7261
Phone: (616) 395-9379
Fax: (616) 820-1457
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601004658 (MI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA0000001490 (TN)

Record details

NPI number1639108293
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 3, 2006
Last updated in NPPESSeptember 13, 2023
Certification dateSeptember 13, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Jack A Dekkinga Md Pc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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