EVELYN JACKSON (NPI# 1457330821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457330821 |
| Entity Type | Individual |
| Full Name | EVELYN JACKSON |
| Credential | CRNA |
| Practice Address |
5898 Augusta Ln Grand Blanc MI 48439-9472 |
| Mailing Address |
5623 E Dunbar Rd Monroe MI 48161-9127 |
| Practice Telephone | 7342413891 |
| Practice Fax Number | 7342410014 |
| Mailing Telephone | 7342413891 |
| Mailing Fax Number | 7342410014 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 4704138318 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS PIN | 4308751540 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275625568 | Evelyn Jackson | Military Health Care Provider | 209 Miller Loop, Fort Benning, Columbus, GA 31905-6560 | 2006-09-28 |
| 1568961837 | Evelyn Nicole Jackson | Nurse Practitioner | 36 Pemberton Cv, Jackson, TN 38305 | 2018-02-01 |
| 1770707093 | Evelyn Diane Jackson | Internal Medicine | 3416 Olandwood Ct, Suite 200, Olney, MD 20832-1372 | 2007-04-11 |
| 1326197690 | Evelyn K. Jackson | Nurse Practitioner | 6565 Fannin St, Stb 1160, Houston, TX 77030-2703 | 2007-01-09 |
| Street Address |
5898 AUGUSTA LN |
| City | GRAND BLANC |
| State | MI |
| Zip Code | 48439-9472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598931 | Fady Essi | Pharmacist | 6160 S Saginaw Road, Grand Blanc, 48439, USA 48439 | 2020-11-04 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1457975476 | Lauren Nicole Holmes | Obstetrics & Gynecology | Gme Department, 1 Genesys Pkwy, Grand Blanc, MI 48439 | 2020-06-05 |
| 1366063927 | Hadeel Ghazi Barrawi | Family Medicine | Ascension Genesys Hospital, Office of Medical Education, One Genesys Parkway, Grand Blanc, MI 48439 | 2020-05-05 |
| 1245851427 | Adriana Sharp | Surgery | 1 Genesys, Grand Blanc, MI 48439 | 2020-04-29 |
| 1114485109 | Kristen Milefchik | Case Manager/Care Coordinator | 278 Fox Chase Blvd, Grand Blanc, MI 48439 | 2019-03-08 |
| 1588134175 | Audrie Brook Mullin | Registered Nurse | 2313 E. Hill Rd, Grand Blanc, MI 48439 | 2018-11-27 |
| 1457845703 | Michael Patrick Tuczynski | Family Medicine | One Genesys Parkway Ascension Genesys Hospital, Attn: Debra Shuck, Grand Blanc, MI 48439 | 2018-06-20 |
| 1104318112 | Wellbridge At Genesys Health Park, LLC | Skilled Nursing Facility | 3139 East Baldwin Road, Grand Blanc, MI 48439 | 2018-06-05 |
| 1336648393 | Raedeane Kenway | Dental Hygienist | 8542 Holly Rd, Grand Blanc, MI 48439 | 2018-02-06 |
| Find all providers in zip 48439 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932744091 | Sean S Vanderwaal | Nurse Anesthetist, Certified Registered | 1420 Perry Rd Apt 1-8, Grand Blanc, MI 48439-1727 | 2019-11-13 |
| 1336703966 | Samuel Alanson Turner | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy Ste 2432, Grand Blanc, MI 48439-8065 | 2019-04-29 |
| 1528017670 | Lisa R Cook | Nurse Anesthetist, Certified Registered | 2432 Genesys Pkwy, Grand Blanc, MI 48439 | 2006-05-08 |
| 1437763737 | Jordan Thomas Bozzo | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 | 2020-09-03 |
| 1710502364 | Mark D Burkhart | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 | 2020-06-10 |
| 1750946372 | Olena Kostyuk | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy Ste 2432, Grand Blanc, MI 48439-8065 | 2019-05-08 |
| 1316501877 | Lindsay Taylor Gburek | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 | 2019-04-30 |
| 1013446681 | Kara Pavone | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 | 2017-06-07 |
| 1720523681 | Brian Joseph Flynn | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy, Suite 2432, Grand Blanc, MI 48439-8065 | 2017-01-03 |
| 1467996322 | Lisa Vecore | Nurse Anesthetist, Certified Registered | 1 Genesys Pkwy, Grand Blanc, MI 48439-8065 | 2016-12-12 |
| Find all providers in GRAND BLANC | ||||
| City | GRAND BLANC |
| Zip Code | 48439 |
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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.