KRISHNA JAKKULA (NPI# 1558719906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558719906 |
| Entity Type | Individual |
| Full Name | KRISHNA JAKKULA |
| Credential | NP-C |
| Practice Address |
2799 West Grand Blvd Henry Ford Health System Detroit MI 48002 |
| Practice Telephone | 2485227848 |
| Mailing Telephone | 2485227848 |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704268080 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2799 WEST GRAND BLVD HENRY FORD HEALTH SYSTEM |
| City | DETROIT |
| State | MI |
| Zip Code | 48002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184683674 | Ann M Woodward | Surgery | 2799 West Grand Blvd, Cfp-123, Detroit, MI 48202 | 2006-03-22 |
| 1922669761 | David Lu | Student in an Organized Health Care Education/Training Program | 2799 West Grand Blvd, Detroit, MI 48202 | 2019-06-24 |
| 1124550132 | Ayodeji Joshua Omosule | Anesthesiology | 2799 West Grand Blvd, Henry Ford Hospital, Medical Education Department, Detroit, MI 48202-2608 | 2017-03-29 |
| 1558725127 | Mohsin Sikendar Fidai | Student in an Organized Health Care Education/Training Program | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48202 | 2016-04-11 |
| 1336521194 | Katie Ellen Gardner | Internal Medicine | 2799 West Grand Blvd, Attention:l K17, Pulmonary and Critical Care Medicine, Detroit, MI 48202 | 2015-06-29 |
| 1336564467 | Marquita C Ratcliff | General Acute Care Hospital | 2799 West Grand Blvd, Detroit, MI 48202 | 2014-02-26 |
| 1831533710 | Katherine Rose Flannery | Emergency Medicine | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48202 | 2013-04-23 |
| 1538426655 | Henry Ford Health System | Long Term Care Hospital | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48101-2608 | 2012-04-13 |
| 1558639609 | Shruti Bassi | Anesthesiology | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48202 | 2011-12-05 |
| 1376825851 | Preetika Kataria | Student in an Organized Health Care Education/Training Program | 2799 West Grand Blvd, Henry Ford Hospital, Detroit, MI 48202 | 2011-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306203492 | Rambling Cowgirl, LLC | Massage Therapist | 13935 Masters Rd, Allenton, MI 48002-2716 | 2016-01-21 |
| 1497810733 | Cheryl Ann Savage | Physical Therapy Assistant | 14055 Gilbert Rd, Allenton, MI 48002-3800 | 2006-12-27 |
| 1538511027 | Justin Bruyneel | Technician, Other | 748 Sperry Rd, Allenton, MI 48002-3818 | 2016-07-07 |
| 1477107035 | Anthony Robert Ford | Chore Provider | 15154 Gould Rd, Allenton, MI 48002-4206 | 2019-07-31 |
| 1225669401 | Comfort Care Companion LLC | In Home Supportive Care | 15154 Gould Rd, Allenton, MI 48002-4206 | 2020-01-28 |
| 1760083208 | Ramonna Van Alstine | Nurse Practitioner | 13932 Fox Ridge Ln, Allenton, MI 48002-4525 | 2020-11-02 |
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750808648 | Mattie B. Johnson | Nurse Practitioner | 13599 Virgil St, Detroit, MI 48223-3050 | 2017-08-23 |
| 1184176984 | Amanda Marie Allmacher | Nurse Practitioner | 50 E Canfield St Ste 101-s, Detroit, MI 48201-1804 | 2016-10-27 |
| 1144774472 | Angela Jayne Wolf | Nurse Practitioner | 7409 2nd Ave, Apt. A2, Detroit, MI 48202-2700 | 2016-08-03 |
| 1912263914 | Tonia Anitra Willis | Nurse Practitioner | 14102 Saint Marys St, Detroit, MI 48227 | 2012-04-04 |
| 1861624058 | Angela Faye Woodley-williams | Nurse Practitioner | 11260 E Jefferson Ave, Detroit, MI 48214-3320 | 2009-08-20 |
| 1740394055 | Mary Patricia Lange | Nurse Practitioner | 4601 John R, Detroit, MI 48201 | 2006-08-17 |
| 1346848827 | Tanya L Locke | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-15 |
| 1720621279 | Rachel Campbell | Nurse Practitioner | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-10-28 |
| 1124679188 | Shanta Nicole Brown | Nurse Practitioner | 16181 Hubbell St, Detroit, MI 48235-4026 | 2019-09-21 |
| 1851866396 | Christopher Childers | Nurse Practitioner | 4160 John R St Ste 930, Detroit, MI 48201-2017 | 2018-10-11 |
| Find all providers in DETROIT | ||||
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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.