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

Audrey Macciomei

Individual provider Physician Assistant · NPI 1639927593

Audrey Macciomei is a Physician Assistant in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2024

Practice location Address checks out

630 Kenmoor Ave SE Ste 103
Grand Rapids, MI 49546-8626
Phone: (616) 600-4950
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601012216 (MI)

Record details

NPI number1639927593
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 7, 2024
Last updated in NPPESMay 7, 2024
Certification dateMay 7, 2024

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