SAVANNAH LYNN MICUNEK (NPI# 1346712288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346712288 |
| Entity Type | Individual |
| Full Name | SAVANNAH LYNN MICUNEK |
| Practice Address |
1221 Sixth St Traverse City MI 49684-2701 |
| Practice Telephone | 2319355730 |
| Mailing Telephone | 2319355730 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2019-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1221 SIXTH ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437139318 | Camille Griswold | Nurse Practitioner | 1221 Sixth St, Suite 206, Traverse City, MI 49684-2701 | 2006-01-18 |
| 1326645698 | Munson Medical Center | Psychiatry & Neurology | 1221 Sixth St, Traverse City, MI 49684-2701 | 2020-10-08 |
| 1942685045 | Munson Medical Center | Neurological Surgery | 1221 Sixth St, Ste 100, Traverse City, MI 49684-2701 | 2015-07-30 |
| 1417385956 | Victoria Cammarata | Social Worker | 1221 Sixth St, Suite 206, Traverse City, MI 49684-2701 | 2013-10-18 |
| 1114275377 | Daniel Thomas Muladore | Physician Assistant | 1221 Sixth St, Suite 202, Traverse City, MI 49684-2701 | 2012-08-20 |
| 1538479357 | J. Eric Zimmerman, M.d., P.C. | Neurological Surgery | 1221 Sixth St, Suite 303, Traverse City, MI 49684-2701 | 2010-10-14 |
| 1912225400 | Munson Medical Center | Internal Medicine | 1221 Sixth St, Ste. 212, Traverse City, MI 49684-2701 | 2010-05-10 |
| 1598083362 | Paul F. Davis, M.d., P.l.c. | Neurological Surgery | 1221 Sixth St, Suite 303, Traverse City, MI 49684-2701 | 2010-05-04 |
| 1356517734 | Christopher Steven Ledtke | Internal Medicine | 1221 Sixth St, Suite 206, Traverse City, MI 49684-2701 | 2008-05-05 |
| 1306966908 | Adrian S. Seah | Surgery | 1221 Sixth St, Suite 306, Traverse City, MI 49684-2701 | 2007-03-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
| 1538579784 | Kevin Coles | Physician Assistant | 1105 Sixth St, Traverse City, MI 49684-2349 | 2014-04-28 |
| 1154623080 | Elizabeth Christine Erickson | Physician Assistant | 1105 Sixth St, Traverse City, MI 49684-2345 | 2010-11-29 |
| 1518294495 | Kacie Ann Freeborn | Physician Assistant | 4045 West Royal Drive, Traverse City, MI 49684-8965 | 2009-11-12 |
| 1508190851 | Andrew Wallace Freeborn | Physician Assistant | 1105 Sixth St, Traverse City, MI 49684-2345 | 2009-09-18 |
| 1710901517 | Ralph A Geraci | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2006-07-26 |
| 1629092424 | Larry D Alexander | Physician Assistant | 1221 Sixth St Ste 300, Traverse City, MI 49684-2360 | 2006-07-26 |
| 1770505638 | Amy P Kudary | Physician Assistant | 4045 W Royal Dr, Traverse City, MI 49684-8965 | 2006-07-23 |
| 1407898810 | Karen A Tosiello | Physician Assistant | 4110 Copper Ridge Dr, Suite 242, Traverse City, MI 49684-7255 | 2006-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1881822187 | Shea Mace | Physician Assistant | 6799 West Grand Blvd, Detroit, MI 48202 | 2009-06-24 |
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| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.