Provider Demographics
NPI:1770574220
Name:PAWLOSKI, MAUREEN B (MSN, APRN, BC)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:B
Last Name:PAWLOSKI
Suffix:
Gender:F
Credentials:MSN, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 E PARIS AVE SE
Mailing Address - Street 2:STE 200
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3691
Mailing Address - Country:US
Mailing Address - Phone:616-949-8554
Mailing Address - Fax:616-949-6557
Practice Address - Street 1:1000 E PARIS AVE SE
Practice Address - Street 2:STE 200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3691
Practice Address - Country:US
Practice Address - Phone:616-949-8554
Practice Address - Fax:616-949-6557
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704169294363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health