LISA SONIA MACLELLAN (NPI# 1629637921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629637921 |
| Entity Type | Individual |
| Full Name | LISA SONIA MACLELLAN |
| Credential | FNP-C |
| Practice Address |
3250 Woods Way Ste 5 Petoskey MI 49770-7628 |
| Mailing Address |
5200 W Beeman Rd Empire MI 49630-9739 |
| Practice Telephone | 2318819700 |
| Practice Fax Number | 2318819698 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-08-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704242836 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5200 W Beeman Rd, Empire, MI 496309739 | 5612759798 |
| Street Address |
3250 WOODS WAY STE 5 |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-7628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
| Find all providers in zip 49770 | ||||
| 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 |
|---|---|---|---|---|
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1982266896 | Shelly Marie Dale | Nurse Practitioner | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2019-07-01 |
| 1336708643 | Hannah Rose Duby | Nurse Practitioner | 560 W Mitchell St Ste 400, Petoskey, MI 49770-2274 | 2019-06-10 |
| 1699268805 | Spencer Cross | Nurse Practitioner | 116 W Mitchell St, Petoskey, MI 49770-2357 | 2018-06-12 |
| 1629578703 | Timothy Amborski | Nurse Practitioner | 820 Arlington Ave, Petoskey, MI 49770-2469 | 2018-02-15 |
| 1568980787 | Ariana Spiewak | Nurse Practitioner | 116 W Mitchell St, Petoskey, MI 49770-2357 | 2017-09-08 |
| 1043767395 | Jennifer Erin Mcbride | Nurse Practitioner | 1 Hiland Dr, Petoskey, MI 49770-2483 | 2016-09-03 |
| 1376945402 | Cynthia Myers Dryer | Nurse Practitioner | 560 W. Mitchell St., Suite 170, Petoskey, MI 49970 | 2014-09-19 |
| 1508295908 | Joann Haderer | Nurse Practitioner | 2202 Mitchell Park Dr, Unit 5, Petoskey, MI 49770-8897 | 2013-11-06 |
| 1134421084 | Joshua D Martin | Nurse Practitioner | 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 | 2010-11-29 |
| Find all providers in PETOSKEY | ||||
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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.