Individual provider · Type 1 NPI
Molly Jane Tiesenga, APRN
Adult Health Nurse Practitioner · Grand Rapids, MI
NPI number
1063977932
Active
Practice location
426 Michigan St NE
Grand Rapids, MI 49503-5609
Mailing address
100 Michigan St NE # MC845
Grand Rapids, MI 49503-2560
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 4704313324 (MI) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 10021431 (OR) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1063977932
Molly Jane Tiesenga, APRN's National Provider Identifier is 1063977932, issued on Feb 5, 2019. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Grand Rapids, MI. The record was last updated on Apr 3, 2024.