Individual
MARIE P NIZIENSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
245 CHERRY ST SE, SUITE 202, GRAND RAPIDS, MI 49503-4607
(616) 459-3551
(616) 459-1060
Mailing address
245 CHERRY ST SE, SUITE 202, GRAND RAPIDS, MI 49503-4607
(616) 459-3551
(616) 459-1060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006046
MI
Other
Enumeration date
06/30/2011
Last updated
03/21/2022
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