Provider Demographics
NPI:1740151125
Name:NAEYAERT, AUDREY C
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:C
Last Name:NAEYAERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 CO RD 513
Mailing Address - Street 2:
Mailing Address - City:RAPID RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49878
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8775 CO RD 513
Practice Address - Street 2:
Practice Address - City:RAPID RIVER
Practice Address - State:MI
Practice Address - Zip Code:49878
Practice Address - Country:US
Practice Address - Phone:906-202-9320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant