Individual
AMANDA LYNN NIENHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-3139
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008068
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/14/2016
Last updated
08/11/2022
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