Individual
MARIELLEN WAZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3009 N SAGINAW RD, MIDLAND, MI 48640-4555
(989) 633-1350
(989) 633-1353
Mailing address
3009 N SAGINAW RD, MIDLAND, MI 48640-4555
(989) 633-1350
(989) 633-1353
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001316
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008807
NCCPA# WAZNY
MI
Enumeration date
07/18/2006
Last updated
07/08/2007
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