Myslenski, Mallory Ann
Myslenski, Mallory Ann is an individual health care provider with primary practice located at 2122 Health Dr Sw Ste 133 , Wyoming MI 49519-9698. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Myslenski, Mallory Ann can be contacted via phone (616) 252-5950.Contact Information
Primary practice address
2122 Health Dr Sw Ste 133
Wyoming MI 49519-9698
Phone: (616) 252-5950
Fax: (616) 252-5956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AG06180160 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | AG06180160 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | AG06180160 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | AG06180160 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4704301141 | Michigan |
Profile Details
| NPI number | 1366937716 |
|---|---|
| LBN Legal business name | Myslenski, Mallory Ann |
| Credentials | AGNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2018 |
| Last updated | Feb 5th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366937716 | NPPES |
| Michigan | MEDICAID | 1366937716 |
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