KALLIE RAE KRAKER (NPI# 1578065140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578065140 |
Entity Type | Individual |
Full Name | KALLIE RAE KRAKER |
Practice Address |
4118 Kalamazoo Ave Se Grand Rapids MI 49508-3605 |
Mailing Address |
1809 Edgewood Ave Se Grand Rapids MI 49506-5112 |
Practice Telephone | 6164867093 |
Mailing Telephone | 6167237491 |
Enumeration Date | 2018-02-28 |
Last Update Date | 2018-02-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704280159 | MI | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
4118 KALAMAZOO AVE SE |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49508-3605 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750365532 | Spectrum Health Continuing Care | Nursing Facility/Intermediate Care Facility | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2005-12-05 |
1083212245 | Jennifer Renee Jacobs | Nurse Practitioner | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2020-10-11 |
1740750546 | Amy Elizabeth Sanders | Nurse Practitioner | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-12-05 |
1639672512 | Marianne Mullins-macritchie | Physical Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-16 |
1346743465 | Jillian Lee Bartsch | Occupational Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-15 |
1609379882 | Nermin Soliman | Occupational Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-14 |
1396248597 | Lori Lee Bultinck | Occupational Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-14 |
1255834479 | Kari Ondersma | Occupational Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-14 |
1538662150 | Kristin Lousise Vanderark | Physical Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-09 |
1124520887 | Katie Marie Yates | Physical Therapist | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-03-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
Find all providers in zip 49508 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154893956 | Jacquelyn Dunn | Nurse Practitioner | 630 Kenmoor Ave Se Ste 102, Grand Rapids, MI 49546-8626 | 2018-12-19 |
1558900183 | Kathryn Long | Nurse Practitioner | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2019-12-30 |
1134690761 | Koren Gebben | Nurse Practitioner | 1959 East Paris Ave Se, Grand Rapids, MI 49546-6272 | 2018-12-07 |
1841775483 | Stacy Lu Allen | Nurse Practitioner | 35 Michigan St Ne Ste 4150, Grand Rapids, MI 49503-2529 | 2018-09-29 |
1538654835 | Anna Marie Rykse | Nurse Practitioner | 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503 | 2018-06-28 |
1083122790 | Christopher Michael Bouma | Nurse Practitioner | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2018-01-16 |
1144732850 | Michelle Kristine Buist | Nurse Practitioner | 35 Michigan St Ne, Grand Rapids, MI 49503-2514 | 2017-11-03 |
1952810830 | Kaitlin Jane Hendriksma | Nurse Practitioner | 550 Cherry St Se, Grand Rapids, MI 49503-4748 | 2017-09-24 |
1962954354 | Samantha Lynne Wylie | Nurse Practitioner | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503-2528 | 2016-11-01 |
1881061497 | Carole Lenzo | Nurse Practitioner | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2015-08-31 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 49508 |
Please comment or provide details below to improve the information on KALLIE RAE KRAKER.
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.