LACEY CAROLINE GARDNER (NPI# 1679758254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679758254 |
Entity Type | Individual |
Full Name | LACEY CAROLINE GARDNER |
Credential | PA-C |
Practice Address |
1970 Ashland Dr Mount Pleasant MI 48858-1203 |
Practice Telephone | 9897795262 |
Practice Fax Number | 9897726784 |
Mailing Telephone | 9897795262 |
Mailing Fax Number | 9897726784 |
Enumeration Date | 2008-01-02 |
Last Update Date | 2013-02-27 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 5601005080 | MI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BLUE CROSS BLUE SHIELD | 010Z960170 | 01 |
MI | BCBS | 080B610040 | 01 |
MI | MEDICARE PTAN | 0Z96017 | 01 |
MI | MEDICARE GROUP | 0Z96017 | 01 |
MI | MEDICARE GROUP NUMBER | MI1118 | 01 |
MI | MEDICARE GROUP NUMBER | 0P43930 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790226504 | Lacey Gardner | Physician Assistant | 865 Deshong Dr, Paris, TX 75460-9313 | 2017-03-13 |
Street Address |
1970 ASHLAND DR |
City | MOUNT PLEASANT |
State | MI |
Zip Code | 48858-1203 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235624396 | Alexis Stevens | Nurse Practitioner | 1970 Ashland Dr, Mount Pleasant, MI 48858-1203 | 2018-06-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215535067 | Family Tree Maternity Center, LLC | Midwife | 5201 S. Mission Rd., Mt. Pleasant, MI 48858 | 2020-10-14 |
1942842471 | Isabella Citizens for Health, Inc. | Pharmacy | 2790 Health Parkway, Mt Pleasant, MI 48858 | 2019-10-16 |
1295299279 | Dalten Tyler Simnitch | Student in an Organized Health Care Education/Training Program | 3700 E Deerfield Rd, Lexington Ridge E01, Mount Pleasant, MI 48858 | 2019-01-24 |
1942773809 | Jordan Lynn Bell | Technician, Other | 798 S Whilteville Rd, Mount Pleasant, MI 48858 | 2019-01-03 |
1083183578 | Amanda Danielle Greene | Student in an Organized Health Care Education/Training Program | 1280 E. Campus Dr., Central Michigan University, Mt. Pleasant, MI 48858 | 2018-11-14 |
1891264388 | Emily Mccullen | Student in an Organized Health Care Education/Training Program | 1280 E Campus Drive, Central Michigan University, Mount Pleasant, MI 48858 | 2018-11-14 |
1174092662 | Nathaniel Lambie | Student in an Organized Health Care Education/Training Program | 1280 East Campus Drive, Central Michigan University, Mount Pleasant, MI 48858 | 2018-11-14 |
1386110872 | Megan Stahl | Social Worker | 301 S Crapo St Suite 100, Mt.pleasant, MI 48858 | 2018-10-23 |
1710461090 | Beverly Jean Medford | Custodial Care Facility | 9318 E. Pickard Rd., Mount Pleasant Mi, MI 48858 | 2018-09-21 |
1760976211 | Jen Carlesimo | Behavior Technician | Central Autism Treatment Center, 2520 S. University Park Drive, Building D, Mt. Pleasant, MI 48858 | 2018-06-19 |
Find all providers in zip 48858 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144836461 | Michael Joseph Haven | Physician Assistant | 221 Bayfront Dr Unit 224, Mount Pleasant, SC 29464-1825 | 2020-09-22 |
1427677376 | John Swinton | Physician Assistant | 3434 Attley St, Mount Pleasant, SC 29466-6860 | 2020-04-10 |
1639717747 | Jessica Carolann Burt | Physician Assistant | 1300 Hospital Dr Ste 210, Mount Pleasant, SC 29464-3208 | 2019-12-19 |
1942855549 | Jessica Gunn Robinson | Physician Assistant | 804 Runaway Bay Ln Apt F, Mount Pleasant, SC 29464-2961 | 2019-08-09 |
1093283608 | Sida Bai | Physician Assistant | 1280 E Campus Dr Central Michigan University, Mount Pleasant, MI 48859-0001 | 2018-11-13 |
1548756299 | Michael John Wanner | Physician Assistant | 3811 Spring St # 102, Mount Pleasant, WI 53405-1667 | 2018-07-05 |
1629408968 | Alissa Marie Mcmahon | Physician Assistant | 1447 Windsor Way Unit 3, Mount Pleasant, WI 53406-2825 | 2013-11-23 |
1235415860 | Carrie Ann White | Physician Assistant | 2890 Health Pkwy, Mount Pleasant, MI 48858-6931 | 2011-10-27 |
1083247530 | Joshua Delarosa | Physician Assistant | 3801 Spring St, Mount Pleasant, WI 53405-1667 | 2020-02-12 |
1396377883 | Taylor Rae Root | Physician Assistant | 1280 E Campus Dr, Mount Pleasant, MI 48858-3803 | 2020-02-12 |
Find all providers in MOUNT PLEASANT |
City | MOUNT PLEASANT |
Zip Code | 48858 |
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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.