JUSTINE SCHRADER (NPI# 1003285859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003285859 |
| Entity Type | Individual |
| Full Name | JUSTINE SCHRADER |
| Practice Address |
1979 Holland Ave Port Huron MI 48060-8639 |
| Mailing Address |
7244 2nd St Lakeport MI 48059-1903 |
| Practice Telephone | 8109821200 |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2018-03-17 |
| NPI Deactivation Date | 02/06/2018 |
| NPI Reactivation Date | 2018-02-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 4704278975 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704278975 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
4704278975 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
4704278975 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP2800X |
Clinical Nurse Specialist Specialization: Perioperative |
4704278975 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5500 Armstrong Rd, Battle Creek, MI 490377314 | 2699665600 |
| Street Address |
1979 HOLLAND AVE |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-8639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275519183 | Douglas A Krause | Family Medicine | 1979 Holland Ave, Suite C, Port Huron, MI 48060-8639 | 2005-12-22 |
| 1518118470 | Port Huron Family Care Pllc | Clinic/Center | 1979 Holland Ave, Suite C, Port Huron, MI 48060-8639 | 2008-10-08 |
| 1750356325 | Jun Garcia | Family Medicine | 1979 Holland Ave, Suite C, Port Huron, MI 48060-8639 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859731 | Cindy Clare Craig | Nurse Practitioner | 4142 Cranberry Ln, Williamsburg, MI 49690-8641 | 2020-10-19 |
| 1487269536 | Christiane Ines Atowo | Nurse Practitioner | 25420 5 Mile Rd, Redford, MI 48239-3837 | 2020-09-14 |
| 1760095137 | Gina Louise Bennett | Nurse Practitioner | 4871 Harwood Rd, Ionia, MI 48846-9422 | 2020-08-26 |
| 1356953756 | John Westley Mailey Jr. | Nurse Practitioner | 27645 Albert St, Novi, MI 48374-1012 | 2020-08-18 |
| 1356951305 | Michelle Lynn Andriacchi | Nurse Practitioner | 45690 Kenmore St, Shelby Township, MI 48317-4656 | 2020-08-05 |
| 1124646476 | Chand Sheoran | Nurse Practitioner | 3040 Albany Ct, Troy, MI 48083-2595 | 2020-07-13 |
| 1104449214 | Lynn Marie Alexanders-klima | Nurse Practitioner | 6697 Summerdale Ct E, Ypsilanti, MI 48197-6140 | 2020-05-22 |
| 1326660580 | Kristin A Furwa | Nurse Practitioner | 600 Health Park Blvd Ste H, Grand Blanc, MI 48439-2558 | 2020-05-11 |
| 1700412582 | Ashley Ruth Zimmerman | Nurse Practitioner | 6223 Brant Ln, Ypsilanti, MI 48197-8742 | 2020-03-12 |
| 1992339139 | Afusat Ahmed | Nurse Practitioner | 5231 Madison Ave Apt A5, Okemos, MI 48864-1172 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
| City | PORT HURON |
| Zip Code | 48060 |
Please comment or provide details below to improve the information on JUSTINE SCHRADER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.