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

Phelan Wolf Frush, CAA

Individual provider Anesthesiologist Assistant · NPI 1922790781

Phelan Wolf Frush, CAA is an Anesthesiology Assistant in Grand Rapids, Michigan. Qualified in 2023, 3 years ago. Practices as a sole proprietor. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
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Practice location Address checks out

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone: (616) 364-4200
Fax: (616) 364-7347
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 789789850 (MI)

Record details

NPI number1922790781
Entity typeIndividual (Type 1)
GenderFemale
Credentials CAA
Sole proprietorYes
NPI enumeratedMay 22, 2023
Last updated in NPPESJanuary 4, 2024
Certification dateJanuary 4, 2024
Mailing address3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9493

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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