ELIZABETH BOUDIAB (NPI# 1437505054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437505054 |
| Entity Type | Individual |
| Full Name | ELIZABETH BOUDIAB |
| Practice Address |
965 Fee Rd # A110 East Lansing MI 48824-6410 |
| Mailing Address |
1088 Mark St Ypsilanti MI 48197-1607 |
| Practice Telephone | 5173531730 |
| Mailing Telephone | 7346454385 |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
965 FEE RD # A110 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824-6410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1750916979 | Mulin Xiong | Student in an Organized Health Care Education/Training Program | 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 | 2020-03-09 |
| 1821659301 | Tovah Apolonia Aho | Psychiatry & Neurology | Michigan State University Psychiatric Residency, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-06-25 |
| 1912564881 | Asmara Theresa Hoo | Psychiatry & Neurology | 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-05-24 |
| 1790276822 | Traverse Health Clinic and Coalition | Clinic/Center | East Fee Hall 965 Fee Road, Room A222, East Lansing, MI 48824 | 2018-05-24 |
| 1922598515 | Jubin Joseph Cheruvelil | Specialist/Technologist, Other | 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 | 2018-05-18 |
| 1073003257 | Dawn Arvye Contreras | Health Educator | 446 West Circle Dr., Justin S. Morrill Hall of Agriculture, Room 166, East Lansing, MI 48824 | 2018-05-14 |
| 1710406046 | Kimberly Ann Breukink | Social Worker | 463 East Circle Drive, Michigan State University, Counseling and Psychiatric Services, East Lansing, MI 48824 | 2017-09-19 |
| 1043766314 | Ahmed Jouan | Psychiatry & Neurology | 804 Service Rd A217, East Lansing, MI 48824 | 2016-08-28 |
| Find all providers in zip 48824 | ||||
| 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 |
|---|---|---|---|---|
| 1750916979 | Mulin Xiong | Student in an Organized Health Care Education/Training Program | 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 | 2020-03-09 |
| 1043862451 | Ahmed Elshafie | Student in an Organized Health Care Education/Training Program | 788 Service Rd Rm B301788, East Lansing, MI 48824-7013 | 2019-07-15 |
| 1154987741 | Ryan Michael Prusko I | Student in an Organized Health Care Education/Training Program | 804 Service Rd Ste A112, East Lansing, MI 48824-7015 | 2019-05-19 |
| 1255802260 | Thomas Patrick Keegan | Student in an Organized Health Care Education/Training Program | 965 Wilson Rd, East Lansing, MI 48824-6410 | 2018-12-17 |
| 1043795453 | Jonathan Lamont Smith | Student in an Organized Health Care Education/Training Program | 591 N. Shaw Ln., East Shaw Hall E155, East Lansing, MI 48825 | 2018-10-02 |
| 1558857797 | Katie S Rosenthal | Student in an Organized Health Care Education/Training Program | 220 Trowbridge Rd, East Lansing, MI 48824-3407 | 2018-07-10 |
| 1538676788 | Alexander A Farhadi | Student in an Organized Health Care Education/Training Program | 6165 Innkeepers Ct Apt 76, East Lansing, MI 48823-7821 | 2018-01-09 |
| 1659884336 | Mallory Stolicker | Student in an Organized Health Care Education/Training Program | 3636 Coleman Rd Apt 133, East Lansing, MI 48823-6141 | 2017-11-16 |
| 1902254048 | Lydia Reedy | Student in an Organized Health Care Education/Training Program | 155 Oakland Dr, East Lansing, MI 48823-4714 | 2016-05-31 |
| 1851707145 | Zil-e-huma Sheikh | Student in an Organized Health Care Education/Training Program | 4060 Springer Way, Apt 211, East Lansing, MI 48823-8329 | 2014-07-07 |
| Find all providers in EAST LANSING | ||||
| City | EAST LANSING |
| Zip Code | 48824 |
Please comment or provide details below to improve the information on ELIZABETH BOUDIAB.
| 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.