SUSAN MARY KILLAM (NPI# 1629191648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629191648 |
| Entity Type | Individual |
| Full Name | SUSAN MARY KILLAM |
| Credential | RN,MSN,NP |
| Practice Address |
Northwest Michigan Community Health Agency 220 W. Garfield Street Charlevoix MI 49720 |
| Mailing Address |
107 Wood St Charlevoix MI 49720-1626 |
| Practice Telephone | 2315476523 |
| Practice Fax Number | 2315476238 |
| Mailing Telephone | 2315475871 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704087772 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | SK087772 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356718027 | Susan Grace Killam | Counselor | 411 S. Prieur St, Human Development Center, New Orleans, LA 70112 | 2015-08-28 |
| Street Address |
NORTHWEST MICHIGAN COMMUNITY HEALTH AGENCY 220 W. GARFIELD STREET |
| City | CHARLEVOIX |
| State | MI |
| Zip Code | 49720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699989665 | Tamara Lynn Hickman | Nurse Practitioner | Northwest Michigan Community Health Agency, 220 W. Garfield Street, Charlevoix, MI 49720 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1215587498 | Amanda Evans | Dietitian, Registered | 09210 North Pointe Woods Drive, Charlevoix, MI 49720 | 2019-09-18 |
| 1508229980 | Charlevoix Physicians Clinic | Specialist | 14709 W. Upright, Charlevoix, MI 49720 | 2016-04-01 |
| 1881014348 | Tracy Skinner | Social Worker | 220 W. Garfield Ave, Charlevoix, MI 49720 | 2014-04-23 |
| 1720414097 | Jennifer Jean Swenor | Occupational Therapist | 10270 Burnett Rd, Charlevoix, MI 49720 | 2013-09-18 |
| 1801171863 | Leslie Lukins | Pharmacist | 1500 Bridge Street, Charlevoix, MI 49720 | 2011-10-20 |
| 1164670949 | Northwest Michigan Community Health Agency | Hospice Care, Community Based | 220 W Garfield Street, Charlevoix, MI 49720 | 2008-09-04 |
| 1275722191 | Robert Dennis Cook | Pharmacist | 301 Bridge Street, Charlevoix, MI 49720 | 2007-10-16 |
| 1851410153 | Joelle M Beaudoin | Specialist/Technologist | 06510 M-66 N, Charlevoix, MI 49720 | 2007-03-28 |
| 1326173659 | Porter & Associates Dds PC | Dentist | 201 Bridge Park Drive, Charlevoix, MI 49720 | 2007-02-23 |
| Find all providers in zip 49720 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (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. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922488436 | Charlevoix Area Hospital | Nurse Practitioner | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2015-06-01 |
| 1942607098 | Karen J Hadley | Nurse Practitioner | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2014-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | CHARLEVOIX |
| Zip Code | 49720 |
Please comment or provide details below to improve the information on SUSAN MARY KILLAM.
| 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.