Provider Demographics
NPI:1518236736
Name:SIERZANT, BRIETNEY JEANNE (PA)
Entity Type:Individual
Prefix:
First Name:BRIETNEY
Middle Name:JEANNE
Last Name:SIERZANT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRIETNEY
Other - Middle Name:JEANNE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-5502
Mailing Address - Country:US
Mailing Address - Phone:231-728-4601
Mailing Address - Fax:
Practice Address - Street 1:1700 CLINTON ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5502
Practice Address - Country:US
Practice Address - Phone:231-728-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006259363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant