Brenda Lee Pawl, M.S.N., A.P.R.N., B.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

L810467 Issued in MI

Practice address

214 Fulton St E Ste 200
Grand Rapids, MI 49503-3211

Phone

(616) 726-2455

Fax

(616) 726-2456

NPI assigned

Dec 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841358918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 FULTON ST E STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033211",
            "telephone_number": "616-726-2455",
            "fax_number": "616-726-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 FULTON ST E STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033211",
            "telephone_number": "616-726-2455",
            "fax_number": "616-726-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWL",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "M.S.N., A.P.R.N., B.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "L810467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Pavlak, PHARM.D.
• Whit Pavlica
• Ashleigh Renee Pavlik, B.S
• Beatrice Pavlik
• Corrin Sade Pawl-Castanon
• Patrick Daniel Pawlaczyk, MD
• Kaitlynn R Pawlak, PT, DPT
• Aryn Jane Pawloski, LMSW
• Maureen B Pawloski, MSN, APRN, BC
• Robert T Pawloski II

• Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.