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

Theodora Ruxandra Nae, PA

Individual provider Physician Assistant · NPI 1780929018

Theodora Ruxandra Nae, PA is a Physician Assistant in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2012.

Licensed in
MI
In the registry since
2012
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

4100 Lake Dr SE
Grand Rapids, MI 49546-8292
Phone: (616) 267-7414
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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 5601006369 (MI)

Record details

NPI number1780929018
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 27, 2012
Last updated in NPPESDecember 12, 2025
Certification dateDecember 12, 2025

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