Individual
AMY D NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MICHIGAN ST NE, 10TH FLOOR, MC 249, GRAND RAPIDS, MI 49503-2560
(616) 267-1925
(616) 267-1005
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004677
MI
Other
Enumeration date
05/27/2006
Last updated
12/15/2021
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