MRS. LONNA PETRONELLA VAN AST


Address: 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786
Phone: 6165500427

MRS. LONNA PETRONELLA VAN AST (NPI# 1093028441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093028441
Entity Type Individual
Full Name MRS. LONNA PETRONELLA VAN AST
Credential P.A.
Practice Address 1022 Ada Place Dr Se
Grand Rapids
MI 49546-3786
Practice Telephone 6165500427
Enumeration Date 2010-07-14
Last Update Date 2013-07-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
5601002990 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1022 ADA PLACE DR SE
City GRAND RAPIDS
State MI
Zip Code 49546-3786

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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285681536 Susan G Laham Physician Assistant 1425 Michigan St Ne, Suite D, Grand Rapids, MI 49503-2027 2006-05-30
1891768065 Paul Loh Physician Assistant 100 Michigan St Ne, Mc 103, Suite 8830, Grand Rapids, MI 49503-2560 2006-02-08
1366439432 Michael Lee Bills Physician Assistant 4100 Lake Dr Se Ste 300, Grand Rapids, MI 49546-8292 2005-10-04
1285633172 Adam J Geller Physician Assistant 1300 Michigan St Ne Ste 200, Grand Rapids, MI 49503-2029 2005-07-21
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1811439763 Danielle Susan Douglass Physician Assistant 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503-2515 2016-11-09
1982078515 Laura E Stevenson Physician Assistant 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2015-11-19
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Competitor

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City GRAND RAPIDS
Zip Code 49546

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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