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NPI Code Detail

MEDICARE: AUBREY MICHELE BRANNICK FNP-BC

MEDICARE:   AUBREY MICHELE BRANNICK  FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner4704300206MI

General Provider Information

NPI Number : 1821440728
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUBREY MICHELE BRANNICK FNP-BC
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25 MICHIGAN ST NE STE 6100
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2561
Country : US
Telephone Number : 616-267-7900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2016
Last Update Date : 11/06/2023

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Directions to “ AUBREY MICHELE BRANNICK FNP-BC” Practice Location

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