MRS. MICHELE MARIE MENTINK (NPI# 1679057517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679057517 |
| Entity Type | Individual |
| Full Name | MRS. MICHELE MARIE MENTINK |
| Credential | NP |
| Practice Address |
400 Hinckley Blvd Ste 100 Jackson MI 49203-6152 |
| Mailing Address |
14174 Elm Row Rd Albion MI 49224-9611 |
| Practice Telephone | 5172058991 |
| Mailing Telephone | 5172060067 |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2018-09-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704274359 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
400 HINCKLEY BLVD STE 100 |
| City | JACKSON |
| State | MI |
| Zip Code | 49203-6152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134565682 | Scott Shelton | Family Medicine | 400 Hinckley Blvd Ste 100, Jackson, MI 49203-6152 | 2013-05-10 |
| 1316438138 | Steven Fehrenbach | Nurse Practitioner | 400 Hinckley Blvd Ste 100, Jackson, MI 49203-6152 | 2018-05-29 |
| 1053854117 | Kasey Gamez | Nurse Practitioner | 400 Hinckley Blvd Ste 100, Jackson, MI 49203-6152 | 2016-11-22 |
| 1891248332 | Jennifer Rose | Physician Assistant | 400 Hinckley Blvd Ste 100, Jackson, MI 49203-6152 | 2016-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
| 1407224280 | Lucinda Gail Taggart | Licensed Practical Nurse | 1515 Greenwood Ave., Jackson, MI 49203 | 2015-09-10 |
| 1134514045 | Christopher Dauterman | Registered Nurse | 1320 East Mcdevitt, Jackson, MI 49203 | 2015-03-30 |
| 1710386826 | Steven Andrew Edwards | Social Worker | 505 Hickory Court, #2d, Jackson, MI 49203 | 2014-08-14 |
| 1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
| 1497014831 | Barbara Cliffe-miller | Physical Therapist | 3510 Page Ave, Jackson, MI 49203 | 2012-05-04 |
| 1871822718 | Sharon Ann Arendsen | Respite Care | 4043 Clarkway Rd, Jackson, MI 49203 | 2009-12-23 |
| 1669700456 | Teresa Lynn Cox | Technician, Other | 3884 Franklin Rd., Jackson, MI 49203 | 2009-12-07 |
| 1942537097 | Stacy Marie Chinevere I | Counselor | 326 Johnson St, Jackson, MI 49203 | 2009-11-11 |
| 1366672370 | Sarah Elizabeth Hazlett | Counselor | 1522joy Avenue, Jackson, MI 49203 | 2009-07-24 |
| Find all providers in zip 49203 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113627 | Jessicah Blasdel | Nurse Practitioner | 113 W Michigan Ave, Jackson, MI 49201-1340 | 2020-10-31 |
| 1801406335 | Jade Russell | Nurse Practitioner | 2205 W Morrell St, Jackson, MI 49203-1357 | 2020-08-10 |
| 1992315212 | Patrecia Campbell | Nurse Practitioner | 2570 Bailey Ave Ste 7, Jackson, MS 39213-6905 | 2020-08-01 |
| 1669008926 | Kristine Edwards | Nurse Practitioner | 723 Woodlawn Ave, Jackson, MI 49203-2921 | 2020-03-19 |
| 1295366391 | Christy White | Nurse Practitioner | 363 Old Pinson Rd, Jackson, TN 38301-9576 | 2020-01-28 |
| 1972141620 | Primary Care - Bemis, LLC | Nurse Practitioner | 1385 S Highland Ave Ste B4, Jackson, TN 38301-7547 | 2019-12-12 |
| 1174164263 | Tami Anne Miller | Nurse Practitioner | 124 N Bast St, Jackson, MO 63755-1704 | 2019-10-01 |
| 1265080584 | Cameron Nicole Howard | Nurse Practitioner | 1860 Chadwick Dr Ste 256, Jackson, MS 39204-3486 | 2019-08-29 |
| 1831750843 | Rhiannon Michelle Andresen | Nurse Practitioner | 1022 Greystone Sq, Jackson, TN 38305-3580 | 2019-06-21 |
| 1902376361 | Jenay B Krumm | Nurse Practitioner | 1201 E Michigan Ave Ste 200, Jackson, MI 49201-1855 | 2018-11-28 |
| Find all providers in JACKSON | ||||
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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.