MRS. CRYSTAL JOSEPHINE SUBOTICH (NPI# 1316219272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316219272 |
| Entity Type | Individual |
| Full Name | MRS. CRYSTAL JOSEPHINE SUBOTICH |
| Credential | R.N. |
| Practice Address |
22170 W 9 Mile Rd Southfield MI 48033-6007 |
| Practice Telephone | 2483726800 |
| Practice Fax Number | 2483551402 |
| Mailing Telephone | 2483726800 |
| Mailing Fax Number | 2483551402 |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2017-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 4704151724 | MI | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704151724 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
22170 W 9 MILE RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48033-6007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962472654 | Satish Kumar Cham | Family Medicine | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2006-01-25 |
| 1912506585 | Amanda Johnson | Case Manager/Care Coordinator | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-10-23 |
| 1083213987 | Patrick Murray | Case Manager/Care Coordinator | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-10-21 |
| 1629682851 | Richard Armstrong | Social Worker | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-09-04 |
| 1770196529 | Marcus Orr | Case Manager/Care Coordinator | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-08-30 |
| 1558973222 | Alyssa Anderson | Social Worker | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-08-23 |
| 1275141863 | Stephanie Longmire | Case Manager/Care Coordinator | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-07-20 |
| 1801419635 | Gabrielle Adanna Ogu | Social Worker | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-05-27 |
| 1578186987 | Zachary Manns | Case Manager/Care Coordinator | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-05-19 |
| 1508491226 | Raya Marie Lasiewski | Case Manager/Care Coordinator | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2020-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531243 | Kenicka Harper | Case Manager/Care Coordinator | 2270 W Nine Mile Rd, Detroit, MI 48033 | 2020-06-03 |
| 1154955292 | Judy C Staples | Registered Nurse | 23800 West 10 Mile Road, Ste. 110, Southfield, MI 48033 | 2020-02-27 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1558862433 | Oakwood Accountable Care Organization, LLC | Preferred Provider Organization | 26901 Beaumont Blvd., Southfield, MI 48033 | 2018-02-26 |
| 1891228904 | Brandi Becker-wright | Social Worker | 25200 Telegraph Rd Ste 100, Southfield, MI 48033 | 2017-04-05 |
| 1003362252 | Mark Kline | Registered Nurse | 22170 W Nine Mile Rd, Southfield, MI 48033 | 2016-08-28 |
| 1033534797 | Jessica Savageau | Social Worker | 22170 W 9 Mile, Southfield, MI 48033 | 2014-03-04 |
| Find all providers in zip 48033 | ||||
| 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 |
|---|---|---|---|---|
| 1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
| 1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
| 1518435486 | Benjamin Delaney | Nurse Practitioner | 29500 Southfield Rd Ste 100, Southfield, MI 48076-2036 | 2018-11-08 |
| 1104255058 | Marie D Libbey | Nurse Practitioner | 21751 W 11 Mile Rd, Suite #105, Southfield, MI 48076-3712 | 2013-11-01 |
| 1598003915 | Duren Ray Gutierrez | Nurse Practitioner | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2013-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 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 |
| 1801343942 | Gwendolyn K La Croix | Nurse Practitioner | 7521 N Telegraph Rd Ste 1, Newport, MI 48166-9398 | 2016-09-07 |
| 1548630296 | Eric Darnall | Nurse Practitioner | 3309 Ravena Ave, Royal Oak, MI 48073-2111 | 2015-10-06 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48033 |
Please comment or provide details below to improve the information on MRS. CRYSTAL JOSEPHINE SUBOTICH.
| 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.