KATHLEEN KUBACKI (NPI# 1073164935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073164935 |
| Entity Type | Individual |
| Full Name | KATHLEEN KUBACKI |
| Practice Address |
1853 R W Berends Dr Sw Wyoming MI 49519-4955 |
| Mailing Address |
3583 Kiel St Hudsonville MI 49426-1307 |
| Practice Telephone | 6165349300 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703116155 | MI | Nursing Service Providers |
| Street Address |
1853 R W BERENDS DR SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49519-4955 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881086965 | Thelma Cases Fowler | Licensed Practical Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2015-02-25 |
| 1003435751 | Elizabeth Jane Pitcher | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2020-04-13 |
| 1578198636 | Nila Yeo | Licensed Practical Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2020-03-10 |
| 1598390171 | Barbara Gardner | Licensed Practical Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2020-03-04 |
| 1629609755 | Joyce Van Hoff | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2020-01-28 |
| 1598305310 | Kelsey Blystone | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2020-01-09 |
| 1881233898 | Tina Krystiniak | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2019-12-23 |
| 1235786559 | Leah Stegenga | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2019-08-21 |
| 1104472133 | Sheryl Conine | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2019-08-15 |
| 1134775661 | Jenna Tefend | Registered Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2019-08-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
| 1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
| 1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
| 1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
| 1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
| Find all providers in zip 49519 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780087 | Ashley M Mannisto | Licensed Practical Nurse | 2445 Miami Ave Sw, Wyoming, MI 49519-2129 | 2020-02-03 |
| 1013576503 | Margaret Stewart | Licensed Practical Nurse | 145 Murray St Sw, Wyoming, MI 49548-3161 | 2019-06-10 |
| 1053798652 | Jillian Berzley | Licensed Practical Nurse | 2724 Edmonton St Sw, Wyoming, MI 49519-4570 | 2015-05-03 |
| 1942693734 | Lena King | Licensed Practical Nurse | 4324 Colby Ave Sw, Wyoming, MI 49509-4423 | 2015-03-18 |
| 1881086965 | Thelma Cases Fowler | Licensed Practical Nurse | 1853 R W Berends Dr Sw, Wyoming, MI 49519-4955 | 2015-02-25 |
| 1831580596 | Pamela Slawson | Licensed Practical Nurse | 5657 Haughey Ave Sw, Wyoming, MI 49548-5735 | 2015-02-16 |
| 1407254832 | Emme P Ekanem | Licensed Practical Nurse | 2112 Audobon St Sw, Wyoming, MI 49519-2206 | 2014-12-17 |
| 1891193777 | Jose Torres | Licensed Practical Nurse | 4224 Stonebridge Dr Sw Apt 2, Wyoming, MI 49519-5229 | 2014-12-09 |
| 1619395456 | Mildred Rebecca Rinehart | Licensed Practical Nurse | 3165 Englehurst Ave Sw, Wyoming, MI 49548-1032 | 2014-03-30 |
| 1912213653 | Mica Latice Craig | Licensed Practical Nurse | 1921 Parkcrest Dr Sw, Apt 9, Wyoming, MI 49519-9330 | 2010-08-18 |
| Find all providers in WYOMING | ||||
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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.