KRISTIN KAY SULLIVAN JANSSEN (NPI# 1164603346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164603346 |
| Entity Type | Individual |
| Full Name | KRISTIN KAY SULLIVAN JANSSEN |
| Practice Address |
4646 John R St Detroit MI 48201-1916 |
| Mailing Address |
2001 Stanhope St Grosse Pointe Woods MI 48236-1905 |
| Practice Telephone | 3135764310 |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 1884007 | MI | Nursing Service Providers |
| Street Address |
4646 JOHN R ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344121 | Christopher Emil Hermann | Nurse Practitioner | 4646 John R St, Detroit, MI 48201-1916 | 2005-05-24 |
| 1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
| 1598371544 | Sonia Govil | Dietitian, Registered | 4646 John R St, Detroit, MI 48201-1916 | 2020-09-16 |
| 1740893569 | Nicholas Edward Peters | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-31 |
| 1710597455 | Amber Michelle Young | Social Worker | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-07 |
| 1104434471 | Zeinab H Moussa | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-22 |
| 1235747346 | Samantha Beth Lewis | Psychologist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-15 |
| 1477171189 | Rima Mohammad Fardos | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-09 |
| 1992323869 | Sarah F Waqhar | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-08 |
| 1619594181 | Mellisa Ann Boyle | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and 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 |
|---|---|---|---|---|
| 1003417783 | Tawana Danielle Williams | Registered Nurse | 866 Blaine St, Detroit, MI 48202-1938 | 2020-11-08 |
| 1528684099 | Barbara Ann Bracey | Registered Nurse | 6309 Mack Ave # 48207, Detroit, MI 48207-2302 | 2020-06-22 |
| 1891325049 | Karen Elizabeth Lacombe | Registered Nurse | 2925 Russell Street, Detroit, MI 48207-4825 | 2020-01-16 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1588220222 | John S Inthavongsa | Registered Nurse | 454 W Alexandrine St Apt 18, Detroit, MI 48201-1787 | 2019-05-17 |
| 1578036083 | Prevention Safe | Registered Nurse | 15429 Appoline St, Detroit, MI 48227-4007 | 2019-01-07 |
| 1831669175 | Amber Lenay Burnett | Registered Nurse | 19650 Telegraph Rd, Detroit, MI 48219-1624 | 2018-11-29 |
| 1285117085 | Kenyata Hamilton-carter | Registered Nurse | 8136 Sirron St, Detroit, MI 48234-3314 | 2018-09-08 |
| 1003309063 | Marquita Outlaw | Registered Nurse | 8290 Coyle St, Detroit, MI 48228 | 2018-06-13 |
| 1558850768 | Doshaun Rene Edwards | Registered Nurse | 16151 Meyers Rd, Detroit, MI 48235-4108 | 2018-05-02 |
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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.