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

Shana Goetting Broxup, PA

Individual provider Physician Assistant · NPI 1326715202

Shana Goetting Broxup, PA is a Physician Assistant in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3230 Eagle Park Dr NE Ste 100
Grand Rapids, MI 49525-7047
Phone: (616) 988-2229
Fax: (616) 988-2010
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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 5601010535TMP21 (MI)

Record details

NPI number1326715202
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 27, 2021
Last updated in NPPESAugust 27, 2021
Certification dateAugust 27, 2021

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