Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pennock State Street Center

Organization Medical Physician Assistant · NPI 1932490885

Pennock State Street Center is a Medical Physician Assistant in Hastings, Michigan. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
2

Practice location Address checks out

1108 W State St
Hastings, MI 49058-9711
Phone: (269) 948-3360
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1932490885
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Poholski — Director · (616) 975-1845
NPI enumeratedApril 27, 2011
Last updated in NPPESApril 2, 2019
Mailing address4100 Embassy Dr Se, Suite 200, Grand Rapids, MI 49546-2416

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