AMBER JOY GUSTAFSON (NPI# 1063669778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063669778 |
| Entity Type | Individual |
| Full Name | AMBER JOY GUSTAFSON |
| Credential | PA |
| Practice Address |
2845 Us 2 & 41 Suite 201 Bark River MI 49807 |
| Practice Telephone | 9064662000 |
| Practice Fax Number | 9064662067 |
| Mailing Telephone | 9064662000 |
| Mailing Fax Number | 9064662067 |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2014-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601005343 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BLUE SHIELD | AG005343 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811442155 | Amber Gustafson | Marriage & Family Therapist | 75 Hassan St Se, Hutchinson, MN 55350-2521 | 2016-08-16 |
| Street Address |
2845 US 2 & 41 SUITE 201 |
| City | BARK RIVER |
| State | MI |
| Zip Code | 49807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114416906 | Bellin Health Iron Mountain Inc | Clinic/Center | 2845 Highway Us2 and 41, Suite 202, Bark River, MI 49807 | 2018-05-07 |
| 1114120201 | Dickinson County Healthcare System | Clinic/Center | 2845 Highway Us2 41, Suite 202, Bark River, MI 49807 | 2007-06-07 |
| 1548703218 | Jenni L Polfus | Nurse Practitioner | 2845 Us 2 and 41, Bark River, MI 49807 | 2016-11-29 |
| 1568657336 | Dickinson County Healthcare System | Obstetrics & Gynecology | 2845 Us 2 and 41, Suite 203, Bark River, MI 49807 | 2007-09-13 |
| 1639188253 | Carolyn R Olson | Family Medicine | 2845 Us 2 and 41, Bark River, MI 49807-1929 | 2006-08-05 |
| 1316317415 | Dickinson County Healthcare System | Durable Medical Equipment & Medical Supplies | 2845 Us Highway 2/41 Ste 101, Bark River, MI 49807-9661 | 2015-10-01 |
| 1801805528 | Theodore Oswald | Family Medicine | 2845 Us Highway 2/41, Bark River, MI 49807-9661 | 2006-08-05 |
| 1194237313 | Tonja Trombley | Nurse Practitioner | 2845 Us Highway 2/41, Bark River, MI 49807-9661 | 2017-10-27 |
| 1841579828 | Clara Elizabeth Schultz | Nurse Practitioner | 2845 Us Highway 2/41, Bark River, MI 49807-9661 | 2011-08-09 |
| 1922315969 | Matthew Stephen Lefevre | Physician Assistant | 2845 Us Highway 2/41, Suite 201, Bark River, MI 49807-9661 | 2010-09-13 |
| Find all providers in zip 49807 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932249984 | Cedar Hill Medical PC | Physician Assistant | 2845 Us Highway 2/41, Suite 201, Bark River, MI 49807-9661 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
| City | BARK RIVER |
| Zip Code | 49807 |
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| 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.