BROOKE WANSHON (NPI# 1588013973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588013973 |
| Entity Type | Individual |
| Full Name | BROOKE WANSHON |
| Credential | MS, RN, CPNP-PC |
| Practice Address |
2331 Monroe St Dearborn MI 48124-3009 |
| Mailing Address |
11022 Hillcrest St Livonia MI 48150-2922 |
| Practice Telephone | 7346731560 |
| Mailing Telephone | 7346731560 |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704296967 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2331 MONROE ST |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750354692 | M Natacha Umlauf Md Pediatrics Plc | Preventive Medicine | 2331 Monroe St, Dearborn, MI 48124 | 2006-02-10 |
| 1124381462 | Jennata Francis | Pediatrics | 2331 Monroe St, Dearborn, MI 48124-3009 | 2012-06-21 |
| 1508138033 | Leslie Marie Mofrad | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2012-01-30 |
| 1285814574 | Linda Corrine Chicko | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2007-11-05 |
| 1245206044 | Matriosca Natacha Umlauf | Pediatrics | 2331 Monroe St, Dearborn, MI 48124-3009 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1043826092 | Kristina Rose Mason | Nurse Practitioner | 18501 Rotunda Dr, Dearborn, MI 48124-3891 | 2020-09-16 |
| 1982239158 | Alexa Christine Bidigare | Nurse Practitioner | 5901 Chase Rd Ste 110, Dearborn, MI 48126-0900 | 2020-03-09 |
| 1215570957 | Ronia Berry | Nurse Practitioner | 6401 Miller Rd, Dearborn, MI 48126-2363 | 2019-10-25 |
| 1730661687 | Jessica L Ott | Nurse Practitioner | 23351 Ford Rd, Dearborn, MI 48128-1258 | 2018-09-06 |
| 1508138033 | Leslie Marie Mofrad | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2012-01-30 |
| 1790079986 | Kerri Ahern Bernard | Nurse Practitioner | 2845 Monroe St, Dearborn, MI 48124-3491 | 2011-06-05 |
| 1548593353 | Stephanie Lynn Pritula | Nurse Practitioner | 18501 Rotunda Dr, Suite 200, Dearborn, MI 48124-3891 | 2009-09-10 |
| 1083858757 | Tiffany Anna Harris | Nurse Practitioner | 2845 Monroe St, Dearborn, MI 48124-3491 | 2009-04-26 |
| 1285814574 | Linda Corrine Chicko | Nurse Practitioner | 2331 Monroe St, Dearborn, MI 48124-3009 | 2007-11-05 |
| Find all providers in DEARBORN | ||||
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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.