Provider Demographics
NPI:1740669456
Name:WEESSIES, ANNE JAE (PA-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:JAE
Last Name:WEESSIES
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:
Practice Address - Street 1:4100 LAKE DR SE
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8292
Practice Address - Country:US
Practice Address - Phone:616-267-9295
Practice Address - Fax:616-267-9296
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2021-02-19
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant