MICHELLE HUSTAD (NPI# 1588122923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588122923 |
| Entity Type | Individual |
| Full Name | MICHELLE HUSTAD |
| Practice Address |
13460 N 94th Dr Ste J1 Peoria AZ 85381-4264 |
| Practice Telephone | 6238768816 |
| Practice Fax Number | 6232980168 |
| Mailing Telephone | 6238768816 |
| Mailing Fax Number | 6232980168 |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
7365 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 504592 | 05 | |
| AZ | ARIZONA BOARD OF PHYSICIAN ASSISTANTS | 7365 | 01 |
| Street Address |
13460 N 94TH DR STE J1 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933957 | Jeffrey M Greenberg | Internal Medicine | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2005-06-27 |
| 1013480771 | Matthew S Burrows | Nurse Practitioner | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2019-01-05 |
| 1730651951 | Lauren Amanda Spano | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4264 | 2018-12-28 |
| 1841765435 | Kara E Seabrook | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2018-10-10 |
| 1427547934 | Janette Carrillo | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2018-05-09 |
| 1093250870 | Jenna Leigh Volstromer | Registered Nurse | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2017-01-03 |
| 1962951392 | Lindsay N Collins | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2016-09-27 |
| 1891243713 | Rebecca Ann Dillon | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2016-09-20 |
| 1417310657 | Weston Debry | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2016-04-04 |
| 1770958449 | Andrea Loren Willcox | Physician Assistant | 13460 N 94th Dr Ste J1, Peoria, AZ 85381-4246 | 2015-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1174956031 | Kindal Alysse Sweet | Physician Assistant | 7677 W Paradise Ln Apt 1128, Peoria, AZ 85382-4974 | 2013-08-14 |
| 1831246669 | Joseph B Earl | Physician Assistant | 7615 W Thunderbird Rd Ste 105, Peoria, AZ 85381-6083 | 2007-01-04 |
| 1275612681 | James Anthony Caruso | Physician Assistant | 9601 North Lindbergh Dr, # 230, Peoria, IL 61615 | 2006-11-04 |
| 1922103407 | Brady Paul Nelson | Physician Assistant | 13943 N . 91st Ave Building I, Peoria, AZ 85381-3692 | 2006-09-13 |
| 1689786444 | Bruce A Ropte | Physician Assistant | 21731 N. 77th Avenue, Peoria, AZ 85382 | 2006-08-31 |
| 1265543391 | Elizabeth D Moore | Physician Assistant | 8940 N Wood Sage Road, Peoria, IL 61615 | 2006-08-31 |
| 1174500581 | Janis Suzann Forch | Physician Assistant | 7615 W Thunderbird Rd, Ste 106, Peoria, AZ 85381-6083 | 2005-12-28 |
| 1508858754 | Kenneth B Caton | Physician Assistant | 9165 W Thunderbird Rd, Ste 100, Peoria, AZ 85381 | 2005-08-15 |
| Find all providers in PEORIA | ||||
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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.