ABIGAIL JEAN ANTONIDES NP NPI 1093596819

NPI Information

  • NPI: 1093596819
  • Provider Name: ABIGAIL JEAN ANTONIDES, NP
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 145 MICHIGAN ST NE STE 3410
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 391-9945

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NPI Details

Abigail Jean Antonides, NP is a gerontology nurse practitioner in Grand Rapids, MI with 3 years of experience. Abigail Jean Antonides, NP NPI is 1093596819. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI
ZIP 49503-563
Phone: (616) 391-9945

The NPI 1093596819 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/9/2023 and was last updated on 10/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LG0600XNurse PractitionerGerontology4704322678MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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