JACQUELYN CLEMONS (NPI# 1417476151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417476151 |
| Entity Type | Individual |
| Full Name | JACQUELYN CLEMONS |
| Credential | LLBSW |
| Practice Address |
4300 6th St Ecorse MI 48229-1110 |
| Mailing Address |
9348 Tobine St Romulus MI 48174-3365 |
| Practice Telephone | 3137246192 |
| Mailing Telephone | 3132850156 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-09-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | MI | Student, Health Care |
| Street Address |
4300 6TH ST |
| City | ECORSE |
| State | MI |
| Zip Code | 48229-1110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588107171 | Devoted Transportation Inc. | Non-emergency Medical Transport (VAN) | 3865 W Jefferson Ave, Ecorse, MI 48229 | 2016-11-30 |
| 1093187577 | Orchard Afc | Custodial Care Facility | 73 Orchard Street, Ecorse, MI 48229 | 2015-10-23 |
| 1780060434 | Jason John Hawkins | Home Health Aide | 18 E Glenwood, Ecorse, MI 48229 | 2015-08-05 |
| 1871866475 | Positive Images | Substance Abuse Rehabilitation Facility | 13336 E.warren, Detroit, MI 48229 | 2012-02-14 |
| 1508964255 | Dean's Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4328 7th Street, 4329 7th Street, Ecorse, MI 48229 | 2006-09-20 |
| 1023124120 | Downriver Industrial Clinic PC | Chiropractor | 4005 W Jefferson Avenue, Ecorse, MI 48229 | 2006-08-22 |
| 1780021147 | Susan Ann Barnes | Registered Nurse | 4488 1st St, Ecorse, MI 48229-1027 | 2013-05-25 |
| 1033267265 | Christine Anne Miller | Specialist/Technologist | 4267 6th St, Ecorse, MI 48229-1109 | 2007-01-05 |
| 1770070872 | Tiffany Sparks | Licensed Practical Nurse | 4170 16th St, Ecorse, MI 48229-1239 | 2018-04-16 |
| 1487180980 | Nolan Grey Home Care Agency and Resource Center | In Home Supportive Care | 4119 19th St, Ecorse, MI 48229-1244 | 2017-05-04 |
| Find all providers in zip 48229 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648940 | Danielle Johne | Student in an Organized Health Care Education/Training Program | 1623 W Sharon Rd Sw, Fife Lake, MI 49633-7214 | 2020-11-01 |
| 1285234062 | Christopher Michael Kemp | Student in an Organized Health Care Education/Training Program | 1710 Hermitage Rd, Ann Arbor, MI 48104-4503 | 2020-10-29 |
| 1326647728 | Sevcan Turk | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Uh B2-a209, Dept. of Radiology, Neuroradiology Division, Ann Arbor, MI 48109-5030 | 2020-10-19 |
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1083221345 | Katelynn Ann Millard | Student in an Organized Health Care Education/Training Program | 3710 Tartan Cir, Portage, MI 49024-4094 | 2020-09-29 |
| 1952918377 | Ereny Demian | Student in an Organized Health Care Education/Training Program | 443 Phillips Ave, Clawson, MI 48017-1546 | 2020-09-29 |
| 1629685151 | Nicole Hiltner | Student in an Organized Health Care Education/Training Program | 391 Quail Ridge Ct, Waterford, MI 48327-4332 | 2020-09-29 |
| 1306453303 | Eddie D Williams | Student in an Organized Health Care Education/Training Program | 507 Pearl St, Ypsilanti, MI 48197-2076 | 2020-09-24 |
| 1538774849 | Grace Frederickson | Student in an Organized Health Care Education/Training Program | 820 Meadow Dr, Wayland, MI 49348-1369 | 2020-09-14 |
| 1215541685 | Rebecca Frey | Student in an Organized Health Care Education/Training Program | 3955 Mayfair St, Dearborn Heights, MI 48125-3039 | 2020-09-03 |
| Find all providers with the same taxonomy | ||||
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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.