Individual
STACEY A PNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1959 E PARIS AVE SE, GRAND RAPIDS, MI 49546-6272
(616) 808-2695
(616) 808-2697
Mailing address
1959 E PARIS AVE SE, GRAND RAPIDS, MI 49546-6272
(616) 808-2695
(616) 808-2697
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005529
MI
Other
Enumeration date
06/15/2009
Last updated
12/11/2014
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