KYLIE PETZAK (NPI# 1407317944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407317944 |
| Entity Type | Individual |
| Full Name | KYLIE PETZAK |
| Credential | RN |
| Practice Address |
920 Diana St Ludington MI 49431-1987 |
| Practice Telephone | 2318456294 |
| Practice Fax Number | 2318457095 |
| Mailing Telephone | 2318456294 |
| Mailing Fax Number | 2318457095 |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 4704342180 | MI | Nursing Service Providers |
| Street Address |
920 DIANA ST |
| City | LUDINGTON |
| State | MI |
| Zip Code | 49431-1987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275646309 | West Michigan Community Mental Health System | Counselor | 920 Diana St, Ludington, MI 49431-1987 | 2006-08-15 |
| 1174121255 | Ana Mccallum | Counselor | 920 Diana St, Ludington, MI 49431-1987 | 2020-10-12 |
| 1366074072 | Haleigh Mcnally | Social Worker | 920 Diana St, Ludington, MI 49431-1987 | 2020-02-11 |
| 1659903375 | Alexa Schneider | Social Worker | 920 Diana St, Ludington, MI 49431-1987 | 2020-02-11 |
| 1922642214 | Amanda Vanduinen | Counselor | 920 Diana St, Ludington, MI 49431-1987 | 2019-10-30 |
| 1346892379 | Lori Mae Stakenas-schneider | Social Worker | 920 Diana St, Ludington, MI 49431-1987 | 2019-07-10 |
| 1528623782 | Sara Hutchinson | Counselor | 920 Diana St, Ludington, MI 49431-1987 | 2019-05-03 |
| 1376017889 | West Michigan Community Mental Health System | Nurse Practitioner | 920 Diana St, Ludington, MI 49431-1987 | 2019-01-17 |
| 1912479544 | Mary Raymond | Counselor | 920 Diana St, Ludington, MI 49431-1987 | 2018-12-20 |
| 1790257327 | Erika Reinhardt | Counselor | 920 Diana St, Ludington, MI 49431-1987 | 2018-12-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972006690 | Marti Miller | Physical Therapist | 5916 Iris Rd., Ludington, MI 49431 | 2018-03-09 |
| 1700258670 | Leslie Hahn Ezdebski | Registered Nurse | 318 River St., Suite B, Manistee, MI 49431 | 2015-10-30 |
| 1477888618 | Kathleen M Tooman | Orthotic Fitter | 901 E Tinkham Avenue, Ludington, MI 49431 | 2009-10-06 |
| 1790831592 | Roger Edgren Ostling | Social Worker | 1027 N Rath, Ludington, MI 49431 | 2007-01-25 |
| 1487734364 | Kathryn Jean Niemeyer | Nurse Practitioner | 5 Atkinson Drive, Suite #207, Ludington, MI 49431 | 2006-10-16 |
| 1609986405 | Vivek Thakore | Clinic/Center | 5511 West Us 10 Hwy, Ludington, MI 49431 | 2006-08-30 |
| 1295747756 | Barbara Sleder | Nurse Practitioner | 1 North Atkinson Dr, Ludington, MI 49431 | 2006-08-13 |
| 1083653893 | William L Ingle Dc | Chiropractor | 321 N Jebavy Drive, Ludington, MI 49431 | 2006-06-06 |
| 1366429706 | Andrew S Riemer | Ophthalmology | 5959 Lawndale St, Ludington, MI 49431 | 2005-12-28 |
| 1699240085 | Toby Wessel, Lmsw, Pllc | Social Worker | 612 Sherman Oaks Dr, Ludington, MI 49431 | 2018-10-11 |
| Find all providers in zip 49431 | ||||
| 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 |
|---|---|---|---|---|
| 1538614169 | Lisa Hammond-koskey | Registered Nurse | 3720 W Hansen Rd, Ludington, MI 49431-8604 | 2016-08-24 |
| 1275015851 | Hilary Wright | Registered Nurse | 920 Diana St, Ludington, MI 49431-1987 | 2018-08-30 |
| 1962992958 | Jennifer Lyn Jeffries | Registered Nurse | 505 W Ludington Ave, Ludington, MI 49431 | 2018-05-15 |
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|---|---|---|---|---|
| 1003417783 | Tawana Danielle Williams | Registered Nurse | 866 Blaine St, Detroit, MI 48202-1938 | 2020-11-08 |
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| 1609475912 | The Wellness Touch | Registered Nurse | 427 Campbell Ave, Kalamazoo, MI 49006-3006 | 2020-10-19 |
| 1790383214 | Megan Trenary | Registered Nurse | 306 Grant St, Chelsea, MI 48118-1212 | 2020-10-16 |
| 1497353908 | Timothy Joseph Petipren | Registered Nurse | 205 S Columbia Ave, Scottville, MI 49454-1205 | 2020-10-16 |
| 1386242634 | Lamuriel Lewis | Registered Nurse | 1430 South Telegraph Rd, Bloomfield Hills, MI 48302 | 2020-10-09 |
| 1326645714 | Nancy Ann Crabbs | Registered Nurse | 5720 16 Mile Rd Ne, Cedar Springs, MI 49319-8540 | 2020-10-08 |
| 1194322685 | Tamara S Hollman | Registered Nurse | 217 John St, Lyons, MI 48851-5101 | 2020-10-07 |
| 1578170320 | Keyana Nicole Collins | Registered Nurse | 31115 Huntley Sq E Apt 623, Beverly Hills, MI 48025-5336 | 2020-09-25 |
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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.