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1669004404
BRIANA NICOLE TANNER
GRANDVILLE, MI
NPI
1669004404
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Former Name
BRIANA NICOLE OETMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601010171)
Enumeration Date
2020-02-10
Last Update Date
2022-04-06
Business Address
BRIANA NICOLE TANNER PA-C
3185 MACATAWA DR SW STE A
GRANDVILLE, MI 49418-3184
Phone number: 616-391-4500
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Mailing Address
BRIANA NICOLE TANNER PA-C
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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