MS. KELLY MAUREEN PSERES (NPI# 1679883201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679883201 |
| Entity Type | Individual |
| Full Name | MS. KELLY MAUREEN PSERES |
| Credential | ANP-BC |
| Practice Address |
26025 Lahser Rd 2nd Floor Southfield MI 48033-2606 |
| Practice Telephone | 2486631905 |
| Practice Fax Number | 2486631902 |
| Mailing Telephone | 2486631905 |
| Mailing Fax Number | 2486631902 |
| Enumeration Date | 2010-10-17 |
| Last Update Date | 2014-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
4704217337 | MI | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NP LICENSE | 4704217337 | 01 |
| Street Address |
26025 LAHSER RD 2ND FLOOR |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48033-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497736771 | Thomas J Ditkoff | Orthopaedic Surgery | 26025 Lahser Rd, 2nd Floor, Southfield, MI 48033-2601 | 2005-11-14 |
| 1679073191 | Vanita Upendra Koepke | Physical Therapist | 26025 Lahser Rd, Southfield, MI 48033 | 2018-02-21 |
| 1427449727 | Julie Berris | Occupational Therapist | 26025 Lahser Rd, Southfield, MI 48033 | 2015-02-09 |
| 1154760650 | Julie Walters Lipa | Physician Assistant | 26025 Lahser Rd, 2nd Floor, Southfield, MI 48033-2606 | 2013-06-18 |
| 1891092904 | Stephanie Danielle Springer | Physical Therapist | 26025 Lahser Rd, Southfield, MI 48033 | 2011-02-25 |
| 1346569886 | Diana C Lengel | Physical Therapist | 26025 Lahser Rd, Suite 100, Southfield, MI 48033-2606 | 2010-05-24 |
| 1609106871 | Chandra T Charlton | Physical Therapist | 26025 Lahser Rd, Suite 100, Southfield, MI 48033-2606 | 2010-01-11 |
| 1598091704 | Jennifer Carol Rohrborn | Nurse Practitioner | 26025 Lahser Rd, 2nd Floor, Southfield, MI 48033-2606 | 2009-10-22 |
| 1073769162 | Daniel Park | Orthopaedic Surgery | 26025 Lahser Rd, 2nd Floor, Southfield, MI 48033-2606 | 2008-08-08 |
| 1740445170 | Jeffrey Walter Devitt Jr. | Orthopaedic Surgery | 26025 Lahser Rd, 2nd Floor, Southfield, MI 48033-2606 | 2008-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531243 | Kenicka Harper | Case Manager/Care Coordinator | 2270 W Nine Mile Rd, Detroit, MI 48033 | 2020-06-03 |
| 1154955292 | Judy C Staples | Registered Nurse | 23800 West 10 Mile Road, Ste. 110, Southfield, MI 48033 | 2020-02-27 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1851958706 | William Beaumont Hospital | Clinic/Center | 26901 Beaumont Blvd., D - 5, Community Health, Southfield, MI 48033 | 2019-05-28 |
| 1396302857 | William Beaumont Hospital | Clinic/Center | Beaumont Service Center, 26901 Beaumont Blvd, Community Health, D - 5, Southfield, MI 48033 | 2019-05-21 |
| 1700442597 | Botsford General Hospital | Clinic/Center | 26901 Beaumont Blvd, Beaumont Service Center, Community Health, D - 5, Southfield, MI 48033 | 2019-05-16 |
| 1558862433 | Oakwood Accountable Care Organization, LLC | Preferred Provider Organization | 26901 Beaumont Blvd., Southfield, MI 48033 | 2018-02-26 |
| 1891228904 | Brandi Becker-wright | Social Worker | 25200 Telegraph Rd Ste 100, Southfield, MI 48033 | 2017-04-05 |
| 1003362252 | Mark Kline | Registered Nurse | 22170 W Nine Mile Rd, Southfield, MI 48033 | 2016-08-28 |
| 1033534797 | Jessica Savageau | Social Worker | 22170 W 9 Mile, Southfield, MI 48033 | 2014-03-04 |
| Find all providers in zip 48033 | ||||
| Taxonomy Code | 163WG0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033831 | Shelly Cromerkennedy | Registered Nurse | 14583 Archdale St, Detroit, MI 48227-1441 | 2020-11-02 |
| 1487265559 | Rita N Shah | Registered Nurse | 30957 Franklin Woods Ct, Franklin, MI 48025-1512 | 2020-08-12 |
| 1558972737 | Tia Seale | Registered Nurse | 19001 E 8 Mile Rd Ste 102, Eastpointe, MI 48021-3247 | 2020-08-12 |
| 1568080869 | Aubrey Michelle Dewey | Registered Nurse | 49394 Nicholette, Utica, MI 48317-2282 | 2020-07-13 |
| 1659992311 | Michelle Anne Orrell | Registered Nurse | 8431 Winona Dr, Jenison, MI 49428-9540 | 2020-05-04 |
| 1871146084 | Amber Lee Smith | Registered Nurse | 441 County Road Ml, Negaunee, MI 49866-9084 | 2019-07-17 |
| 1275193450 | Tricia Kay Rosa | Registered Nurse | 6767 Knollview Dr, Hudsonville, MI 49426-9388 | 2019-06-19 |
| 1679047278 | Margiejo D Packham | Registered Nurse | 109 W Memorial Dr, Hancock, MI 49931 | 2019-01-16 |
| 1730654732 | Christine Gabriel | Registered Nurse | 3871 Cheryl Dr, Commerce Township, MI 48382-1723 | 2018-10-05 |
| 1730685132 | Daniel Kueppers | Registered Nurse | 3505 Denton Rd, Canton, MI 48188-2107 | 2018-04-04 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48033 |
Please comment or provide details below to improve the information on MS. KELLY MAUREEN PSERES.
| 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.