Individual
LESLEY ANN NEVENZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2009 HOLTON RD, MUSKEGON, MI 49445-1578
(616) 935-3479
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005892
MI
Other
Enumeration date
09/22/2010
Last updated
06/07/2022
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