Individual
MARY BETH ADYNIEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1246 MADISON AVE SE, GRAND RAPIDS, MI 49507-1761
(616) 685-8300
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-8099
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704131247
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4870508
—
MI
05
—
4878622
—
MI
Enumeration date
07/18/2006
Last updated
06/07/2013
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