SHAWN ALLEN WAITERS SR. (NPI# 1255974390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255974390 |
Entity Type | Individual |
Full Name | SHAWN ALLEN WAITERS SR. |
Credential | NURSE PRACTITIONER |
Practice Address |
2215 Fuller Rd Ann Arbor MI 48105-2303 |
Mailing Address |
929 Birchwood Dr Flushing MI 48433-1401 |
Practice Telephone | 7342227921 |
Mailing Telephone | 8108453045 |
Enumeration Date | 2019-10-22 |
Last Update Date | 2019-10-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704224275 | MI | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2215 FULLER RD |
City | ANN ARBOR |
State | MI |
Zip Code | 48105-2303 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619975075 | Susan M Meador | Pharmacist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2005-07-11 |
1972101103 | Blaine Franklin | Physical Therapist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-10-10 |
1306443262 | Benjamin Pfeifer | Psychologist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-10-05 |
1083223044 | John Zemicki | Pharmacist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-07-27 |
1790394955 | Jyness Ariel Williams | Pharmacist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-07-23 |
1114545761 | Emily Sahagian | Pharmacist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-07-10 |
1831717586 | Jessica Vogt | Physical Therapist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-07-09 |
1881212488 | Scarlett Kettwich | Dentist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-07-09 |
1518584879 | Lauren Mcculley | Pharmacist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-07-02 |
1023634243 | Amanjot Kaur Sarao | Dentist | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-06-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730728718 | Alexander Jendrusina | Psychologist | Va Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105 | 2019-12-23 |
1417515875 | Christine Shyh Wang | Student in an Organized Health Care Education/Training Program | 4029 Avenue Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2019-05-31 |
1013475003 | Ryan Wang | Physician Assistant | 4883 S. Ridgeside Cir, Ann Arbor, MI 48105 | 2019-03-08 |
1801366265 | Amruta Sonavaria | Physical Therapist | 4701 East Huron River Drive, Ann Arbor, MI 48105 | 2018-11-28 |
1568955730 | Alexander Sliwicki | Pediatrics | 1500 East Medical Drive, Medical Professional Building, Ann Arbor, MI 48105 | 2018-06-12 |
1902398464 | Austin Remington | Student in an Organized Health Care Education/Training Program | 4029 Ave Maria Drive, Lobby A, Suite 1200, Ann Arbor, MI 48105 | 2018-05-31 |
1881191658 | Stephen James Hickner | Student in an Organized Health Care Education/Training Program | St. Mary Mercy Outpatient Psychiatric Services, 2006 Hogback Road, Suite 1, Ann Arbor, MI 48105 | 2018-04-09 |
1245681709 | Winnie Nhan | Internal Medicine | 4000 Ave Maria Dr, Lobby C Suite 1300, Ann Arbor, MI 48105 | 2016-06-27 |
1861857971 | Connie Chen | Pharmacist | 2215 Fuller Road (119), Ann Arbor, MI 48105 | 2015-12-17 |
1407241193 | Stefan Craciun | Emergency Medicine | 3484 Ashburnam Rd, Ann Arbor, MI 48105 | 2015-03-31 |
Find all providers in zip 48105 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578164810 | Jessica Leigh Bailey | Nurse Practitioner | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2020-11-03 |
1003381062 | Kelly A Hammill | Nurse Practitioner | 220 N Main St, Ann Arbor, MI 48104-1413 | 2018-10-05 |
1841702586 | Nancy Marie Bigelow | Nurse Practitioner | 2750 S State St, Ann Arbor, MI 48104-6179 | 2017-11-03 |
1235546193 | Citta Mental Health Services | Nurse Practitioner | 3300 Washtenaw Ave, Suite 295, Ann Arbor, MI 48104-4200 | 2014-07-11 |
1568890077 | Leah M Husby | Nurse Practitioner | 2140 E Ellsworth Rd, Ann Arbor, MI 48108-2552 | 2013-10-18 |
1568675403 | Charlotte Ruth Cowles | Nurse Practitioner | 2215 Fuller Rd, Department of Veterans Affairs Medical Center, Ann Arbor, MI 48105-2335 | 2007-05-07 |
1578598470 | Joan Elizabeth Stein | Nurse Practitioner | 2215 Fuller Rd, Ann Arbor, MI 48105-2335 | 2006-07-11 |
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1720692494 | Memphis Chardell Sandoval | Nurse Practitioner | 131 S. Seaway Dr., Muskegon, MI 49441 | 2020-09-01 |
1588282784 | Mary Tackbary | Nurse Practitioner | 3932 W Briar Hill Dr, Maple City, MI 49664-9521 | 2020-07-14 |
1962032227 | Westlake Consultation Center | Nurse Practitioner | 4870 W Clark Rd Ste 100, Ypsilanti, MI 48197-1104 | 2020-01-24 |
1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
1396289120 | Next Level Up Health & Wellness Inc. | Nurse Practitioner | 28423 Parkwood St, Inkster, MI 48141-1669 | 2016-12-13 |
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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.