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

Kiva Da-Shan Bauswell, A-GNP

Individual provider Gerontology Nurse Practitioner · NPI 1508531088

Kiva Da-Shan Bauswell, A-GNP is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2019, 7 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2021
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

145 Michigan St NE Ste 3410
Grand Rapids, MI 49503-2563
Phone: (616) 391-9945
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 4704291746 (MI)

Record details

NPI number1508531088
Entity typeIndividual (Type 1)
GenderFemale
Credentials A-GNP
Sole proprietorNo
NPI enumeratedAugust 16, 2021
Last updated in NPPESMay 4, 2023
Certification dateMay 4, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Grand Rapids