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

Mary L Wisniewski, PA-C

Individual provider Physician Assistant · NPI 1770652810

Mary L Wisniewski, PA-C is a Physician Assistant in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1925 Breton Rd SE
Grand Rapids, MI 49506-4810
Phone: (616) 252-4100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601003060 (MI)

Record details

NPI number1770652810
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 6, 2006
Last updated in NPPESMarch 7, 2023

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