Individual
BREEANNE KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 68TH ST SE, GRAND RAPIDS, MI 49548-6980
(616) 391-8242
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013005
MI
Other
Enumeration date
06/23/2022
Last updated
05/27/2025
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