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41800 W 11 Mile Rd Ste 109 Novi MI 48375-1818 | |
| (248) 860-4634 | |
| (248) 282-5044 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 41800 W 11 Mile Rd Ste 109, Novi, Michigan |
| Authorized Official Name and Position | Justin P Di Rezze (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2488604634 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
41800 W 11 Mile Rd Ste 109 Novi MI 48375-1818 Ph: (248) 860-4634 | 41800 W 11 Mile Rd Ste 109 Novi MI 48375-1818 Ph: (248) 860-4634 |
| NPI Number | 1609362375 |
|---|---|
| Provider Enumeration Date | 07/06/2018 |
| Last Update Date | 09/27/2024 |
| Medicare PECOS PAC ID | 5395098339 |
|---|---|
| Medicare Enrollment ID | O20181004002127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609362375 | NPI | - | NPPES |
| 0411248 | Medicaid | OH |
| Provider Name | Frank L Amprim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639212269 PECOS PAC ID: 9133028624 Enrollment ID: I20040105000123 |
| Provider Name | Charles F Whitaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821054966 PECOS PAC ID: 7911895586 Enrollment ID: I20040305000633 |
| Provider Name | An G Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629024880 PECOS PAC ID: 4385532845 Enrollment ID: I20040306000144 |
| Provider Name | Raafat Issa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750497483 PECOS PAC ID: 8628067972 Enrollment ID: I20040511000800 |
| Provider Name | Kimberly P Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588626592 PECOS PAC ID: 7416936653 Enrollment ID: I20040720000424 |
| Provider Name | Melvin Cherry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386735413 PECOS PAC ID: 6608856596 Enrollment ID: I20040721001501 |
| Provider Name | James L Wierman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942280920 PECOS PAC ID: 9234033416 Enrollment ID: I20040723000289 |
| Provider Name | Brian J Gedeon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285667337 PECOS PAC ID: 8123090347 Enrollment ID: I20040809001035 |
| Provider Name | Christopher B Gong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053497149 PECOS PAC ID: 7012981087 Enrollment ID: I20040825000043 |
| Provider Name | David Georges Raffo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063499291 PECOS PAC ID: 7618945775 Enrollment ID: I20040917000375 |
| Provider Name | Edith Nemeth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841391133 PECOS PAC ID: 1759350986 Enrollment ID: I20040924000961 |
| Provider Name | Padmaja R Mouli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821102633 PECOS PAC ID: 3971555855 Enrollment ID: I20050221000008 |
| Provider Name | Tomas W Abalo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336199975 PECOS PAC ID: 9638126428 Enrollment ID: I20050404000968 |
| Provider Name | Colin David Irish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700947710 PECOS PAC ID: 3274570189 Enrollment ID: I20050412001330 |
| Provider Name | Heminder P Singh |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1659407799 PECOS PAC ID: 9830131259 Enrollment ID: I20050526000140 |
| Provider Name | Robert N Israel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083688261 PECOS PAC ID: 5991749111 Enrollment ID: I20050617000313 |
| Provider Name | Thomas L Bossi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346342235 PECOS PAC ID: 6507801123 Enrollment ID: I20050623001041 |
| Provider Name | Michael Joseph Oneka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366457129 PECOS PAC ID: 6002840402 Enrollment ID: I20050926000074 |
| Provider Name | Ronald E Seagle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699744953 PECOS PAC ID: 7810915550 Enrollment ID: I20051110000601 |
| Provider Name | Jeremy Michael Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497712129 PECOS PAC ID: 1951323435 Enrollment ID: I20051227000558 |
| Provider Name | James Lewis Voigt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649329137 PECOS PAC ID: 1153344627 Enrollment ID: I20060111000068 |
| Provider Name | Julie A Olechnowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730151978 PECOS PAC ID: 6204859531 Enrollment ID: I20060112000342 |
| Provider Name | Ann Yvette Burton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528253689 PECOS PAC ID: 8527082338 Enrollment ID: I20060119000715 |
| Provider Name | Frederick L Bean |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023085693 PECOS PAC ID: 0042225088 Enrollment ID: I20060213000781 |
| Provider Name | Judith A Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255322467 PECOS PAC ID: 9638188055 Enrollment ID: I20060413000071 |
| Provider Name | Amy Falor Field |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710996947 PECOS PAC ID: 0446255996 Enrollment ID: I20060915000576 |
| Provider Name | Amy L Komperda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720172000 PECOS PAC ID: 3971509910 Enrollment ID: I20061013000303 |
| Provider Name | Kevin C Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427150796 PECOS PAC ID: 8729086822 Enrollment ID: I20061128000557 |
| Provider Name | Donald E Willman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184641771 PECOS PAC ID: 6901899194 Enrollment ID: I20070111000415 |
| Provider Name | Flora Ann Dean |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1770632945 PECOS PAC ID: 1557465648 Enrollment ID: I20070329000342 |
| Provider Name | Melody A Angel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770662025 PECOS PAC ID: 8729184403 Enrollment ID: I20070427000051 |
| Provider Name | Keith L Papendick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700992484 PECOS PAC ID: 5799684460 Enrollment ID: I20070611000058 |
| Provider Name | Deniese L Worthy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982730990 PECOS PAC ID: 4082715594 Enrollment ID: I20070727000804 |
| Provider Name | Daniel S Passerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043366842 PECOS PAC ID: 4789776220 Enrollment ID: I20070828000907 |
| Provider Name | Alexander W Runowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154439339 PECOS PAC ID: 3779677851 Enrollment ID: I20070920000113 |
| Provider Name | Ramin Rafie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558471326 PECOS PAC ID: 7416034004 Enrollment ID: I20080407000521 |
| Provider Name | Jaime F Tan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346235207 PECOS PAC ID: 9335210756 Enrollment ID: I20080612000418 |
| Provider Name | Jeri A Swafford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275712457 PECOS PAC ID: 9436223930 Enrollment ID: I20080731000770 |
| Provider Name | Luanne Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851313878 PECOS PAC ID: 0648344770 Enrollment ID: I20080807000148 |
| Provider Name | Joy F Ling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922142561 PECOS PAC ID: 1850467739 Enrollment ID: I20080828000353 |
| Provider Name | Henri Godbold |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1407012834 PECOS PAC ID: 1951478320 Enrollment ID: I20080926000381 |
| Provider Name | Sarah M Somerfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134378532 PECOS PAC ID: 6406915537 Enrollment ID: I20081104000791 |
| Provider Name | Anthony B Janas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437398831 PECOS PAC ID: 6608925052 Enrollment ID: I20090514000456 |
| Provider Name | Eunice Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114196748 PECOS PAC ID: 5698842888 Enrollment ID: I20090604000392 |
| Provider Name | Jill Nocerini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851556344 PECOS PAC ID: 0941350722 Enrollment ID: I20090617000186 |
| Provider Name | Carl E Palffy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144228917 PECOS PAC ID: 3971654062 Enrollment ID: I20090701000249 |
| Provider Name | Dean E Fior |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1780899047 PECOS PAC ID: 9234283771 Enrollment ID: I20090818000183 |
| Provider Name | Alaa A Husseinali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497907778 PECOS PAC ID: 4880749373 Enrollment ID: I20090904000504 |
| Provider Name | Donna Jean Gilliam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114170685 PECOS PAC ID: 9739235391 Enrollment ID: I20090923000247 |
| Provider Name | Donald M Rozzell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760475313 PECOS PAC ID: 8820126212 Enrollment ID: I20100505000496 |
| Provider Name | Terri L Ladwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003066218 PECOS PAC ID: 7012040462 Enrollment ID: I20100805000196 |
| Provider Name | Zahirul Talukder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861678856 PECOS PAC ID: 5294850590 Enrollment ID: I20100909001029 |
| Provider Name | Sally S Young |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1760495550 PECOS PAC ID: 2466644026 Enrollment ID: I20101014000572 |
| Provider Name | Aparna V Gadekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548445620 PECOS PAC ID: 1658564992 Enrollment ID: I20101019001622 |
| Provider Name | Nicole Brandoline Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205153871 PECOS PAC ID: 2961698659 Enrollment ID: I20101119000867 |
| Provider Name | Purvaj Mahendra Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730344029 PECOS PAC ID: 8820279474 Enrollment ID: I20110302000249 |
| Provider Name | Angela Arsenault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003115718 PECOS PAC ID: 5193909414 Enrollment ID: I20110412000380 |
| Provider Name | Michael A Amlog |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215196225 PECOS PAC ID: 4688852809 Enrollment ID: I20110616000798 |
| Provider Name | Uchebike N Nwankwo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962690073 PECOS PAC ID: 7719155498 Enrollment ID: I20110725000227 |
| Provider Name | Eric Cary Brooks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689707333 PECOS PAC ID: 9537339395 Enrollment ID: I20110902000569 |
| Provider Name | Matthew C Slendebroek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942445945 PECOS PAC ID: 6608913470 Enrollment ID: I20111020000519 |
| Provider Name | Husam A Baki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316129695 PECOS PAC ID: 3678464989 Enrollment ID: I20120207000834 |
| Provider Name | Prashanti Franklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952578056 PECOS PAC ID: 1254591761 Enrollment ID: I20120320000928 |
| Provider Name | Lori Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699033548 PECOS PAC ID: 2668625104 Enrollment ID: I20130110000621 |
| Provider Name | Tarrie A Franke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518202753 PECOS PAC ID: 1456506427 Enrollment ID: I20130222000257 |
| Provider Name | Kristina Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962755058 PECOS PAC ID: 3476798455 Enrollment ID: I20130321000564 |
| Provider Name | Haseeb Khawaja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679580104 PECOS PAC ID: 6103882642 Enrollment ID: I20130916000755 |
| Provider Name | Jasmine E Dorsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205149325 PECOS PAC ID: 3577790708 Enrollment ID: I20131216000613 |
| Provider Name | Christine Weglarz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679839161 PECOS PAC ID: 3779711957 Enrollment ID: I20140115000867 |
| Provider Name | James H Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982974143 PECOS PAC ID: 0840453601 Enrollment ID: I20140324001392 |
| Provider Name | Barbara Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598058893 PECOS PAC ID: 8820215411 Enrollment ID: I20140805001553 |
| Provider Name | Victoria D Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417361502 PECOS PAC ID: 4688891450 Enrollment ID: I20140821000718 |
| Provider Name | Courtney S Brinkman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568887909 PECOS PAC ID: 7719105386 Enrollment ID: I20140822000779 |
| Provider Name | Maureen A Ziboh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275560583 PECOS PAC ID: 9830137421 Enrollment ID: I20140828001152 |
| Provider Name | Katrice Woodward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518356682 PECOS PAC ID: 3375869969 Enrollment ID: I20150225001411 |
| Provider Name | Wesley Wendell Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568868404 PECOS PAC ID: 4789903931 Enrollment ID: I20150511000238 |
| Provider Name | Karen Driskill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043603558 PECOS PAC ID: 9830410125 Enrollment ID: I20150611003306 |
| Provider Name | Najab Mohammed Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740620160 PECOS PAC ID: 4385963008 Enrollment ID: I20150630002804 |
| Provider Name | Rehana Qadir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205092236 PECOS PAC ID: 6305095936 Enrollment ID: I20150721001371 |
| Provider Name | Angela Kuklewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578941571 PECOS PAC ID: 5698088334 Enrollment ID: I20150723008369 |
| Provider Name | Cherie L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194196295 PECOS PAC ID: 1557671526 Enrollment ID: I20151103002653 |
| Provider Name | Julie Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467824284 PECOS PAC ID: 7911217468 Enrollment ID: I20151112001379 |
| Provider Name | Lisa M Yacoub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588931059 PECOS PAC ID: 6406153493 Enrollment ID: I20160317001764 |
| Provider Name | Elisabeth R Maodus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457712267 PECOS PAC ID: 2264730431 Enrollment ID: I20160421001018 |
| Provider Name | Eun Ju Yeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891032009 PECOS PAC ID: 0941442610 Enrollment ID: I20160603001241 |
| Provider Name | Elizabeth A Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154770550 PECOS PAC ID: 1052604675 Enrollment ID: I20160720000418 |
| Provider Name | Jenna Leigh Larkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134581994 PECOS PAC ID: 5991003246 Enrollment ID: I20160802002766 |
| Provider Name | Chad Wolinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760847883 PECOS PAC ID: 8729373352 Enrollment ID: I20160822002509 |
| Provider Name | Joseph Eric Gamalski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952741670 PECOS PAC ID: 6608161914 Enrollment ID: I20160825002202 |
| Provider Name | Angela T Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104299163 PECOS PAC ID: 7113224734 Enrollment ID: I20160912000760 |
| Provider Name | Holly M Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013460567 PECOS PAC ID: 2163701806 Enrollment ID: I20161121000200 |
| Provider Name | Rochelle Lenetta Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184083974 PECOS PAC ID: 9638459761 Enrollment ID: I20161207002326 |
| Provider Name | Ancy Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265982235 PECOS PAC ID: 8325329782 Enrollment ID: I20161227001527 |
| Provider Name | Deangella R Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700328135 PECOS PAC ID: 2365724838 Enrollment ID: I20170117002271 |
| Provider Name | Theresa Manteil Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164965703 PECOS PAC ID: 7416239272 Enrollment ID: I20170131002262 |
| Provider Name | Amy L Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780031484 PECOS PAC ID: 9537443866 Enrollment ID: I20170303001149 |
| Provider Name | Dequindra Blakey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417303355 PECOS PAC ID: 3173807419 Enrollment ID: I20170303001827 |
| Provider Name | Justin P Di Rezze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558775700 PECOS PAC ID: 5395037758 Enrollment ID: I20170612000377 |
| Provider Name | John P Wilkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689082539 PECOS PAC ID: 1850669300 Enrollment ID: I20170626000120 |
| Provider Name | Heidi A Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902347685 PECOS PAC ID: 2860762077 Enrollment ID: I20170720002552 |
| Provider Name | Drew J Packey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811302516 PECOS PAC ID: 9830469782 Enrollment ID: I20170725003582 |
| Provider Name | Jennifer L Spitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972026912 PECOS PAC ID: 8921372830 Enrollment ID: I20170915001424 |
| Provider Name | Kirsten Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295269843 PECOS PAC ID: 8820362932 Enrollment ID: I20170927003225 |
| Provider Name | Amanda Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518474402 PECOS PAC ID: 5597024364 Enrollment ID: I20180124001753 |
| Provider Name | Disha Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659885408 PECOS PAC ID: 4587924964 Enrollment ID: I20180202001005 |
| Provider Name | Heather A Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023523891 PECOS PAC ID: 6507126356 Enrollment ID: I20180216000397 |
| Provider Name | Meredith Krugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639684178 PECOS PAC ID: 6901167220 Enrollment ID: I20180301002562 |
| Provider Name | Quinnkeela L Nash-el |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295249951 PECOS PAC ID: 9638432909 Enrollment ID: I20180419001058 |
| Provider Name | Maria Melody-padiernos Wolfinbarger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205342714 PECOS PAC ID: 2668737800 Enrollment ID: I20180517001825 |
| Provider Name | Jennifer Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902305295 PECOS PAC ID: 9739434564 Enrollment ID: I20180620000818 |
| Provider Name | Kathleen M Hartwell King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225520919 PECOS PAC ID: 2365799608 Enrollment ID: I20180718002062 |
| Provider Name | Lashawnda Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851827414 PECOS PAC ID: 1355691387 Enrollment ID: I20180912001181 |
| Provider Name | Josilyn Elise Goebel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184107427 PECOS PAC ID: 5890046908 Enrollment ID: I20180927002650 |
| Provider Name | Timothy Omar Gates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487155024 PECOS PAC ID: 7911259676 Enrollment ID: I20181008000860 |
| Provider Name | Jameelah Ragland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598280596 PECOS PAC ID: 0042565327 Enrollment ID: I20181010001957 |
| Provider Name | Adriene Avripas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790296010 PECOS PAC ID: 4385996677 Enrollment ID: I20181015003508 |
| Provider Name | Alison M Sesock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386123180 PECOS PAC ID: 6002169638 Enrollment ID: I20181030000826 |
| Provider Name | Joan A Matejovsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750857934 PECOS PAC ID: 6800140492 Enrollment ID: I20181119000431 |
| Provider Name | Dawn Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922590512 PECOS PAC ID: 4587908611 Enrollment ID: I20181130000927 |
| Provider Name | Latanya Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396140372 PECOS PAC ID: 0143564658 Enrollment ID: I20181210001575 |
| Provider Name | Darasowan Kiecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457821597 PECOS PAC ID: 4082959564 Enrollment ID: I20190103000979 |
| Provider Name | Robert A Jason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700260015 PECOS PAC ID: 7012253495 Enrollment ID: I20190104002476 |
| Provider Name | Deenah Cavill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174012595 PECOS PAC ID: 5991042251 Enrollment ID: I20190124000087 |
| Provider Name | Fares N Mubarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831753466 PECOS PAC ID: 4688917305 Enrollment ID: I20190521002932 |
| Provider Name | Vincent Dematio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982067096 PECOS PAC ID: 7911290010 Enrollment ID: I20190710000831 |
| Provider Name | Amy Beth M Fuciarelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255815882 PECOS PAC ID: 3870828965 Enrollment ID: I20190711001812 |
| Provider Name | Christine Louise Glowacki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083102214 PECOS PAC ID: 7315272143 Enrollment ID: I20190716001113 |
| Provider Name | Amanda Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831633692 PECOS PAC ID: 3375826191 Enrollment ID: I20190717002144 |
| Provider Name | Gregory S Balloid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902374267 PECOS PAC ID: 5092046235 Enrollment ID: I20191018002040 |
| Provider Name | Hayley L Dunlap-zacek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629631205 PECOS PAC ID: 9931531530 Enrollment ID: I20191120002045 |
| Provider Name | Marcia Antoinette Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629615109 PECOS PAC ID: 1153755228 Enrollment ID: I20191223002234 |
| Provider Name | Tracie Henline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053956532 PECOS PAC ID: 7618302639 Enrollment ID: I20200122001555 |
| Provider Name | Mary Ann Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417423369 PECOS PAC ID: 3072947548 Enrollment ID: I20200210001892 |
| Provider Name | Cindy A Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801432687 PECOS PAC ID: 1951737907 Enrollment ID: I20200211000840 |
| Provider Name | Susan Kay Ercia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740839000 PECOS PAC ID: 0244667400 Enrollment ID: I20200227001897 |
| Provider Name | Eric A Tungol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912384058 PECOS PAC ID: 1759601651 Enrollment ID: I20200327001413 |
| Provider Name | Stephanie Abray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033741178 PECOS PAC ID: 9739518564 Enrollment ID: I20200331000352 |
| Provider Name | Oranu Ibekie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134190713 PECOS PAC ID: 8921074311 Enrollment ID: I20200501000285 |
| Provider Name | Deirdre Tracey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659918258 PECOS PAC ID: 9133550353 Enrollment ID: I20200504000170 |
| Provider Name | Tiffany M Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013535087 PECOS PAC ID: 2365866423 Enrollment ID: I20200722000577 |
| Provider Name | Jean B Jourdan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588130884 PECOS PAC ID: 5496090151 Enrollment ID: I20200722003081 |
| Provider Name | Valerie Dekam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649892001 PECOS PAC ID: 2961826664 Enrollment ID: I20200727003282 |
| Provider Name | Jian Zhang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235756412 PECOS PAC ID: 4587088208 Enrollment ID: I20200728000511 |
| Provider Name | Shawna L Kuhn |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1831135623 PECOS PAC ID: 8022907237 Enrollment ID: I20200805001782 |
| Provider Name | Brian G Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902415193 PECOS PAC ID: 1951728054 Enrollment ID: I20200903002797 |
| Provider Name | Deborah S Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134514458 PECOS PAC ID: 2668784505 Enrollment ID: I20200914000308 |
| Provider Name | Michael Anthony Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144719246 PECOS PAC ID: 2264787068 Enrollment ID: I20200930001109 |
| Provider Name | Jaleesa Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093332546 PECOS PAC ID: 1052730306 Enrollment ID: I20201006001463 |
| Provider Name | Melissa M Outman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326519950 PECOS PAC ID: 1355761412 Enrollment ID: I20201012002638 |
| Provider Name | Luis G Maduro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881813079 PECOS PAC ID: 0042504151 Enrollment ID: I20201022002058 |
| Provider Name | Ann M Quinlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710598461 PECOS PAC ID: 6507286911 Enrollment ID: I20201022002991 |
| Provider Name | Katie Arno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720616477 PECOS PAC ID: 9537570932 Enrollment ID: I20201116000559 |
| Provider Name | Taylor L Pichette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073113460 PECOS PAC ID: 0143631853 Enrollment ID: I20201202001162 |
| Provider Name | Marissa Dawn Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487261392 PECOS PAC ID: 2860804903 Enrollment ID: I20201215001841 |
| Provider Name | Kelcie Danielle Crandall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467094755 PECOS PAC ID: 0941613053 Enrollment ID: I20210111001176 |
| Provider Name | Shahzeb Afsar Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881867380 PECOS PAC ID: 0042489270 Enrollment ID: I20210121001906 |
| Provider Name | Isharon B Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962914366 PECOS PAC ID: 4385902915 Enrollment ID: I20210126002262 |
| Provider Name | Lynne Marie Cappellucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952407744 PECOS PAC ID: 0143226407 Enrollment ID: I20210201001530 |
| Provider Name | Jacarma Crystal Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891279956 PECOS PAC ID: 9931514577 Enrollment ID: I20210212001381 |
| Provider Name | Eowyn Elise Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356937379 PECOS PAC ID: 0648686055 Enrollment ID: I20210310000940 |
| Provider Name | Rebecca M Royce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467030114 PECOS PAC ID: 8729495999 Enrollment ID: I20210406001206 |
| Provider Name | Wei Luo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528659836 PECOS PAC ID: 7618385212 Enrollment ID: I20210420002659 |
| Provider Name | Ligia Gabriela Martinescul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154897809 PECOS PAC ID: 0143639179 Enrollment ID: I20210504001968 |
| Provider Name | Jessica Anne Martinelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679154041 PECOS PAC ID: 5991114662 Enrollment ID: I20210510001241 |
| Provider Name | Ramya Vadlamudi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710249727 PECOS PAC ID: 1254640931 Enrollment ID: I20210611001150 |
| Provider Name | Theodora Chukwudi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063005403 PECOS PAC ID: 5890961742 Enrollment ID: I20210623002718 |
| Provider Name | Gabriela Cristina Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760014690 PECOS PAC ID: 9133520026 Enrollment ID: I20210629003473 |
| Provider Name | Jessica Ann Glahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588230445 PECOS PAC ID: 6507268703 Enrollment ID: I20210712000235 |
| Provider Name | Nagat Taher Albanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528657756 PECOS PAC ID: 2769884980 Enrollment ID: I20210712000706 |
| Provider Name | Monika Krystyna Clay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942896253 PECOS PAC ID: 0648672733 Enrollment ID: I20210712004100 |
| Provider Name | Cheryl Ann Layton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871176644 PECOS PAC ID: 9931501939 Enrollment ID: I20210714000180 |
| Provider Name | Raychelle A Melki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851963714 PECOS PAC ID: 5597168690 Enrollment ID: I20210727003271 |
| Provider Name | Shibani Tipnis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497325476 PECOS PAC ID: 3375946296 Enrollment ID: I20210729000605 |
| Provider Name | Mohamad Sadek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487130662 PECOS PAC ID: 7113275793 Enrollment ID: I20210818000826 |
| Provider Name | Andrea Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699340802 PECOS PAC ID: 1759786270 Enrollment ID: I20210823000405 |
| Provider Name | Dominic Ondieki Abuya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053984609 PECOS PAC ID: 7517363575 Enrollment ID: I20210831002186 |
| Provider Name | Kelly J Wilcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336814490 PECOS PAC ID: 4082010806 Enrollment ID: I20210902001422 |
| Provider Name | Azhar Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841804424 PECOS PAC ID: 0244636348 Enrollment ID: I20210914002704 |
| Provider Name | Erica Jean Roehrig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609547116 PECOS PAC ID: 0749688927 Enrollment ID: I20211004000893 |
| Provider Name | Blessing Duru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780280800 PECOS PAC ID: 3678971587 Enrollment ID: I20211007000487 |
| Provider Name | Rebecca Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245900711 PECOS PAC ID: 3274931506 Enrollment ID: I20211018000584 |
| Provider Name | Archana Mandhare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265195796 PECOS PAC ID: 6406021625 Enrollment ID: I20211026002120 |
| Provider Name | Jessica Marie Terhorst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508528290 PECOS PAC ID: 0143619502 Enrollment ID: I20211105001563 |
| Provider Name | Ashley Edmonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003583824 PECOS PAC ID: 1254721095 Enrollment ID: I20211209000989 |
| Provider Name | Joseph Ojibway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609205533 PECOS PAC ID: 1355570300 Enrollment ID: I20220114000539 |
| Provider Name | Francesca Vitale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659963239 PECOS PAC ID: 5193117406 Enrollment ID: I20220119000529 |
| Provider Name | Gwendolyn Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992390157 PECOS PAC ID: 6406248673 Enrollment ID: I20220120000672 |
| Provider Name | Briana Ranzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750049078 PECOS PAC ID: 1658763719 Enrollment ID: I20220121001579 |
| Provider Name | Chelsea Delisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578195681 PECOS PAC ID: 5294127387 Enrollment ID: I20220124000299 |
| Provider Name | Dyonne Hellen Mansur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316498645 PECOS PAC ID: 2163709601 Enrollment ID: I20220216001305 |
| Provider Name | Zenobia Nah Arreytta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760146427 PECOS PAC ID: 4789078387 Enrollment ID: I20220224001944 |
| Provider Name | Ugoala C Banks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962596700 PECOS PAC ID: 8426055526 Enrollment ID: I20220310001513 |
| Provider Name | Kari Anne Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982361655 PECOS PAC ID: 5799170437 Enrollment ID: I20220316002711 |
| Provider Name | Malak Ibrahim Mashaleh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841944097 PECOS PAC ID: 1658766258 Enrollment ID: I20220317001596 |
| Provider Name | Simone Wafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619629565 PECOS PAC ID: 0042605412 Enrollment ID: I20220322000784 |
| Provider Name | Alicia Jean Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154982783 PECOS PAC ID: 1355728486 Enrollment ID: I20220511001644 |
| Provider Name | Christiane Ines Atowo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487269536 PECOS PAC ID: 2264810555 Enrollment ID: I20220526002465 |
| Provider Name | Lashasta Lashas Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174113245 PECOS PAC ID: 9436537768 Enrollment ID: I20220527001178 |
| Provider Name | Tasha N Hudson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1356708630 PECOS PAC ID: 7315244175 Enrollment ID: I20220609002366 |
| Provider Name | Sonya Deniese Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912556291 PECOS PAC ID: 2769860527 Enrollment ID: I20220609002454 |
| Provider Name | Renee Pollard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932711652 PECOS PAC ID: 5597144527 Enrollment ID: I20220622002751 |
| Provider Name | Guiselly Erazo-romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528551223 PECOS PAC ID: 2365794088 Enrollment ID: I20220720002496 |
| Provider Name | Lakisha Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588315758 PECOS PAC ID: 6103208178 Enrollment ID: I20220808001895 |
| Provider Name | Betty M Mbangwana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528640638 PECOS PAC ID: 0547642464 Enrollment ID: I20220809000575 |
| Provider Name | Ali Mehieddine Nassri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912642869 PECOS PAC ID: 4688056526 Enrollment ID: I20220809001792 |
| Provider Name | Chrystal Terese Eichenlaub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184354763 PECOS PAC ID: 8921481888 Enrollment ID: I20220810002785 |
| Provider Name | Stacy Kate Schubring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508599234 PECOS PAC ID: 0840673620 Enrollment ID: I20220811000150 |
| Provider Name | Rajani Rupesh Kakade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467182964 PECOS PAC ID: 2163805698 Enrollment ID: I20220817000644 |
| Provider Name | Madison Louise Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700504255 PECOS PAC ID: 9032593868 Enrollment ID: I20220829001405 |
| Provider Name | Shauna Richey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285381152 PECOS PAC ID: 3173907680 Enrollment ID: I20220901002053 |
| Provider Name | Esmahan Fayed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346977378 PECOS PAC ID: 3375927890 Enrollment ID: I20220901002432 |
| Provider Name | Mittal A Suthar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164159950 PECOS PAC ID: 6901280429 Enrollment ID: I20220901002497 |
| Provider Name | Jeffrey Michael Eichenlaub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174256747 PECOS PAC ID: 3274917521 Enrollment ID: I20220906000550 |
| Provider Name | Surinder J Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184984502 PECOS PAC ID: 7618887977 Enrollment ID: I20220929003687 |
| Provider Name | Grace-fomboh Kande |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417561416 PECOS PAC ID: 7012393606 Enrollment ID: I20221005001797 |
| Provider Name | Tia L Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700518578 PECOS PAC ID: 5092181537 Enrollment ID: I20221025000390 |
| Provider Name | Elaiza Parado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720712755 PECOS PAC ID: 7618343153 Enrollment ID: I20221025000435 |
| Provider Name | Donnietra La'verne Walls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710654744 PECOS PAC ID: 1456727817 Enrollment ID: I20221026002400 |
| Provider Name | Marissa Claire Niemeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003485194 PECOS PAC ID: 6901208040 Enrollment ID: I20221029000138 |
| Provider Name | Jessica Steinacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609469790 PECOS PAC ID: 5294141768 Enrollment ID: I20221117000898 |
| Provider Name | Misty Ann Schafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386379410 PECOS PAC ID: 2668841453 Enrollment ID: I20221219000921 |
| Provider Name | Melissa Cork |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639899099 PECOS PAC ID: 2961872676 Enrollment ID: I20221221000633 |
| Provider Name | Shirley Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306591011 PECOS PAC ID: 2365812039 Enrollment ID: I20221222000206 |
| Provider Name | Shannon Marie Scanlon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104545292 PECOS PAC ID: 4284006008 Enrollment ID: I20230203001896 |
| Provider Name | Lenea Rae Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558867606 PECOS PAC ID: 1759336605 Enrollment ID: I20230204000450 |
| Provider Name | Seok Kyung Barnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205559655 PECOS PAC ID: 1052783800 Enrollment ID: I20230204000486 |
| Provider Name | Jennifer K Centers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437871290 PECOS PAC ID: 3779955547 Enrollment ID: I20230206000875 |
| Provider Name | Anne Marie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962128512 PECOS PAC ID: 6901278423 Enrollment ID: I20230209003090 |
| Provider Name | Paul Michael Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043919996 PECOS PAC ID: 7315311727 Enrollment ID: I20230327002277 |
| Provider Name | Stephen Matthew White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396441283 PECOS PAC ID: 2860866134 Enrollment ID: I20230328002046 |
| Provider Name | Shahla Forcon Alhuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316673379 PECOS PAC ID: 8628443561 Enrollment ID: I20230407000505 |
| Provider Name | Nina Aleksandrovna Anufriyeva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093416604 PECOS PAC ID: 3476928102 Enrollment ID: I20230412000862 |
| Provider Name | Ednah Kwamboka Makori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013687946 PECOS PAC ID: 4587039979 Enrollment ID: I20230418000478 |
| Provider Name | Mohamad Ali Saad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740913201 PECOS PAC ID: 2365807344 Enrollment ID: I20230426001117 |
| Provider Name | Allison Bazzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053011205 PECOS PAC ID: 0941665673 Enrollment ID: I20230502000305 |
| Provider Name | Melissa Hope Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548975584 PECOS PAC ID: 1951766435 Enrollment ID: I20230505001724 |
| Provider Name | Latricia Richards-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316546344 PECOS PAC ID: 4385019561 Enrollment ID: I20230511003561 |
| Provider Name | Michelle Griffith Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871078055 PECOS PAC ID: 4688092406 Enrollment ID: I20230512001582 |
| Provider Name | Lori Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902566920 PECOS PAC ID: 3072979913 Enrollment ID: I20230518003448 |
| Provider Name | Maha Gebril |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750093308 PECOS PAC ID: 1456717370 Enrollment ID: I20230519000732 |
| Provider Name | Rebecca Elizabeth Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063101277 PECOS PAC ID: 9638535453 Enrollment ID: I20230522002166 |
| Provider Name | Megan Britton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972983690 PECOS PAC ID: 6305151267 Enrollment ID: I20230527000158 |
| Provider Name | Mohammad Mashaleh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639606023 PECOS PAC ID: 9032486220 Enrollment ID: I20230606001768 |
| Provider Name | Sophie Roest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356986012 PECOS PAC ID: 0143687095 Enrollment ID: I20230607002979 |
| Provider Name | Nibha Hetalbhai Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912617200 PECOS PAC ID: 0648637462 Enrollment ID: I20230608002718 |
| Provider Name | Kristen Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174019947 PECOS PAC ID: 4688922933 Enrollment ID: I20230612002488 |
| Provider Name | Deidree Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730816331 PECOS PAC ID: 1850762063 Enrollment ID: I20230621001073 |
| Provider Name | Latricia Denise Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295426450 PECOS PAC ID: 3274991260 Enrollment ID: I20230623000805 |
| Provider Name | Alicia Jill Dunaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881123214 PECOS PAC ID: 4486927217 Enrollment ID: I20230707002397 |
| Provider Name | Teresa Hegwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366802399 PECOS PAC ID: 7012377831 Enrollment ID: I20230712001179 |
| Provider Name | Anthony John Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144921222 PECOS PAC ID: 0648630483 Enrollment ID: I20230712002107 |
| Provider Name | Marcy S Durie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396085890 PECOS PAC ID: 8527296417 Enrollment ID: I20230714000235 |
| Provider Name | Gabriel Takuh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790355907 PECOS PAC ID: 3173983608 Enrollment ID: I20230717000582 |
| Provider Name | Rohan Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649611674 PECOS PAC ID: 0143522557 Enrollment ID: I20230725000548 |
| Provider Name | Natalie Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508210527 PECOS PAC ID: 9537443221 Enrollment ID: I20230727001277 |
| Provider Name | Gabrielle Marie Lindbloom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134738339 PECOS PAC ID: 6507227592 Enrollment ID: I20230808000456 |
| Provider Name | Lori Rutledge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144324864 PECOS PAC ID: 0648277988 Enrollment ID: I20230809001078 |
| Provider Name | Garrett Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053519298 PECOS PAC ID: 0244556694 Enrollment ID: I20230809003764 |
| Provider Name | Keyeriashon Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801271713 PECOS PAC ID: 9032492343 Enrollment ID: I20230810001326 |
| Provider Name | Marvelyn Elfreda Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255901443 PECOS PAC ID: 3274995030 Enrollment ID: I20230811000591 |
| Provider Name | Dongmei Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053097584 PECOS PAC ID: 2961864558 Enrollment ID: I20230814003327 |
| Provider Name | Jeffrey Rayner Lapennas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265114227 PECOS PAC ID: 0244694578 Enrollment ID: I20230919003824 |
| Provider Name | Natosha Lynn Klinesmith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588377915 PECOS PAC ID: 8921452764 Enrollment ID: I20230927001470 |
| Provider Name | Jessica Reviea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003564691 PECOS PAC ID: 6103212535 Enrollment ID: I20231021000549 |
| Provider Name | Amy J Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568248102 PECOS PAC ID: 5294182952 Enrollment ID: I20231117000584 |
| Provider Name | Alitha V Glenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043991771 PECOS PAC ID: 4981053717 Enrollment ID: I20231205003750 |
| Provider Name | Candice Lea Drury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619681566 PECOS PAC ID: 9931559820 Enrollment ID: I20231218004192 |
| Provider Name | Binita Baniya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588446355 PECOS PAC ID: 8426408386 Enrollment ID: I20231219002509 |
| Provider Name | Bianca Fatima Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588437404 PECOS PAC ID: 5597115055 Enrollment ID: I20231223000037 |
| Provider Name | Victoria L Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538949052 PECOS PAC ID: 0446600878 Enrollment ID: I20231228000743 |
| Provider Name | Lauren Rochelle West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942815097 PECOS PAC ID: 9537570023 Enrollment ID: I20240108000422 |
| Provider Name | Amie Elisabeth Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528492998 PECOS PAC ID: 4486889946 Enrollment ID: I20240108005819 |
| Provider Name | Chimerebere Mirian Okafor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891561288 PECOS PAC ID: 1254782584 Enrollment ID: I20240110004154 |
| Provider Name | Jacquelyn Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902531239 PECOS PAC ID: 9739556986 Enrollment ID: I20240129002529 |
| Provider Name | Samer Akrawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154852887 PECOS PAC ID: 5597038315 Enrollment ID: I20240213003647 |
| Provider Name | Brice Galbraith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538851852 PECOS PAC ID: 5092151548 Enrollment ID: I20240307000767 |
| Provider Name | Shannon Kemper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770038481 PECOS PAC ID: 5890074389 Enrollment ID: I20240314000118 |
| Provider Name | Nicole Schanta Rusinowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558086819 PECOS PAC ID: 4183061724 Enrollment ID: I20240319002145 |
| Provider Name | Marina May Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649954397 PECOS PAC ID: 2062850118 Enrollment ID: I20240409001324 |
| Provider Name | Molly Irizarry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790140283 PECOS PAC ID: 7911325840 Enrollment ID: I20240508001377 |
| Provider Name | Laura Elders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134974447 PECOS PAC ID: 3274975495 Enrollment ID: I20240520002537 |
| Provider Name | Victoria Paige Mclaughlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992554604 PECOS PAC ID: 3072057744 Enrollment ID: I20240705001192 |
| Provider Name | Kelechi Akubukwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437763406 PECOS PAC ID: 9739590647 Enrollment ID: I20240707000058 |
| Provider Name | Dennis M Feihel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437511805 PECOS PAC ID: 7113261629 Enrollment ID: I20240708003323 |
| Provider Name | Michelle Camarata-stress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023789740 PECOS PAC ID: 7113462276 Enrollment ID: I20240712001851 |
| Provider Name | Ericka Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164294062 PECOS PAC ID: 7810433968 Enrollment ID: I20240724003953 |
| Provider Name | Cailin L Mcdaniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427806926 PECOS PAC ID: 1456897461 Enrollment ID: I20240726001018 |
| Provider Name | Pamela Tarras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194776153 PECOS PAC ID: 4082623178 Enrollment ID: I20240805003434 |
| Provider Name | Kimberly Lynn Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407375207 PECOS PAC ID: 8325585201 Enrollment ID: I20240809000515 |
| Provider Name | Fatima Mabalot Cortez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508431792 PECOS PAC ID: 9931649951 Enrollment ID: I20240905001064 |
| Provider Name | Muhammad Arshad |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932595105 PECOS PAC ID: 5193028744 Enrollment ID: I20240920000230 |
| Provider Name | Suleman Ajaz Janjua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518520469 PECOS PAC ID: 6204372196 Enrollment ID: I20240920003114 |
| Provider Name | Crystal Joy Bendele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184304016 PECOS PAC ID: 5496296956 Enrollment ID: I20240924002826 |
| Provider Name | Tyler Mclaughlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053152504 PECOS PAC ID: 5890236210 Enrollment ID: I20240925000553 |
| Provider Name | Renee Clare Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114608858 PECOS PAC ID: 3971034000 Enrollment ID: I20241001000977 |
| Provider Name | Samreen Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154151637 PECOS PAC ID: 2769913722 Enrollment ID: I20241001002269 |
| Provider Name | Haileah A Friend |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164005971 PECOS PAC ID: 0648679746 Enrollment ID: I20241004000871 |
| Provider Name | Tara Lynn Lanz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801620828 PECOS PAC ID: 7719100288 Enrollment ID: I20241015002016 |
| Provider Name | Tiffany Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568237956 PECOS PAC ID: 3072051937 Enrollment ID: I20241018003207 |
| Provider Name | Rania Dado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043067465 PECOS PAC ID: 7113450370 Enrollment ID: I20241025002061 |
| Provider Name | Jordan Walker |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205570561 PECOS PAC ID: 3678952074 Enrollment ID: I20241025003607 |
| Provider Name | Maya Lubus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013735745 PECOS PAC ID: 9739613191 Enrollment ID: I20241108000399 |
| Provider Name | Gandhi Bhattarai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588433346 PECOS PAC ID: 8628509809 Enrollment ID: I20241112001720 |
| Provider Name | Hannah Jane Thayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053980854 PECOS PAC ID: 8527593557 Enrollment ID: I20241127000631 |
| Provider Name | John Okolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912439647 PECOS PAC ID: 0244585925 Enrollment ID: I20241130000230 |
| Provider Name | Victoria Keyton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124008461 PECOS PAC ID: 4284641523 Enrollment ID: I20241202001152 |
| Provider Name | Juliana Mwose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134424708 PECOS PAC ID: 3476731993 Enrollment ID: I20241203001341 |
| Provider Name | Benjamin Owen Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003512856 PECOS PAC ID: 7214463025 Enrollment ID: I20241203004542 |
| Provider Name | Tiara Dolores Rudzinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346078052 PECOS PAC ID: 8325574874 Enrollment ID: I20241209000794 |
Silverton Medical Partners Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21333 Haggerty Rd, Suite 150, Novi, MI 48375 Phone: 248-662-0250 Fax: 248-662-9845 | |
Aftab Ahmad Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 47601 Grand River Ave, C106, Novi, MI 48374 Phone: 248-790-3087 | |
P & A Of Farmington Hills, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 44150 W 12 Mile Rd, Ste 100, Novi, MI 48377 Phone: 248-867-8706 | |
Brookside Internal Medicine, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 24230 Karim Blvd, Suite 130, Novi, MI 48375 Phone: 248-919-1100 | |
Medfix P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 47601 Grand River Ave, Suite B-230, Novi, MI 48374 Phone: 248-465-4444 | |
General Medicine Of Mo Physicians, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21333 Haggerty Rd, Suite 150, Novi, MI 48375 Phone: 248-662-0250 Fax: 248-662-9844 | |
Family Care Physicians, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 39500 W. Ten Mile Rd, Suite 100, Novi, MI 48375 Phone: 248-476-0035 Fax: 248-476-2418 |