Healthcare Provider Details

I. General information

NPI: 1427977073
Provider Name (Legal Business Name): DR. DANIELLE KOESTNER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 GRAND BLUFFS DR SW
GRAND RAPIDS MI
49534-8608
US

IV. Provider business mailing address

50 LOUIS ST NW STE 613
GRAND RAPIDS MI
49503-2674
US

V. Phone/Fax

Practice location:
  • Phone: 616-706-4179
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIELLE KOESTNER
Title or Position: OWNER
Credential: DO
Phone: 616-706-4179