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Michelle Lynn Magnusson

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

35 Michigan St NE Ste 4150, Grand Rapids, MI 49503-2529

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE MAGNUSSON.

Based on the most recent information from CMS, provider Michelle Lynn Magnusson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 1:10 PM.

Profile Details

Provider ID
1497411623
Provider Type
Individual
Full Name
Magnusson, Michelle Lynn
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
11/11/2021
Last Updated
4/6/2022

Contact Information

Practice Location

35 Michigan St NE Ste 4150, Grand Rapids, MI 49503-2529

(616) 267-2600

Unlisted Fax

Mailing Location

100 Michigan St NE # Mc845, Grand Rapids, MI 49503-2560

(616) 486-6790

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5601010911 Michigan

Michelle Lynn Magnusson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Benso, Brent

West, Angela Lynn

Shaw, Emily Noelle

Witte, Kristin

Stevens, Mackenzie

Cerny, Ryan J

Towns, Jenna Anne

Arnett, Mara Gray

Hoff, Cody Keith

Wainscott, Teresa L