Healthcare Provider Details

I. General information

NPI: 1538536966
Provider Name (Legal Business Name): ALISON AUBRY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISON RYAN NP

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7751 BYRON CENTER AVE SW STE C
BYRON CENTER MI
49315-8001
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC 845
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 616-267-7725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704283212
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704283212
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: