JENNIFER REBECCA DYKSTRA (NPI# 1720136955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720136955 |
Entity Type | Individual |
Full Name | JENNIFER REBECCA DYKSTRA |
Credential | PHARM.D. |
Practice Address |
550 Munson Ave Suite G100 Traverse City MI 49686-3580 |
Mailing Address |
1720 Apache Pass Traverse City MI 49686-2817 |
Practice Telephone | 2319358730 |
Mailing Telephone | 2319220232 |
Enumeration Date | 2007-01-05 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | 5302031831 | MI | Pharmacy Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548685225 | Jennifer Dykstra | Registered Nurse | 8801 W. Angel Dr, Wasilla, AK 99654 | 2014-03-04 |
1497700868 | Jennifer Dykstra | Nurse Practitioner | 4139 Little Star Ct Sw, Grandville, MI 49418-3021 | 2006-05-24 |
1700216108 | Jennifer Dykstra | Nurse Practitioner | 117 W Paterson St, Kalamazoo, MI 49007-2557 | 2013-11-21 |
Street Address |
550 MUNSON AVE SUITE G100 |
City | TRAVERSE CITY |
State | MI |
Zip Code | 49686-3580 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205839131 | William H. George | Internal Medicine | 550 Munson Ave, Traverse City, MI 49686 | 2005-05-24 |
1265054936 | Erynne Louise Russell | Speech-Language Pathologist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2020-05-15 |
1821624545 | Susan Carol Spencer | Speech-Language Pathologist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2020-03-13 |
1346807617 | Mary Priestly | Physician Assistant | 550 Munson Ave, Traverse City, MI 49686-3580 | 2019-05-22 |
1194380493 | Kimberly A Chandler | Health Educator | 550 Munson Ave, Traverse City, MI 49686-3580 | 2019-05-02 |
1942770946 | Caroline Kiley | Physical Therapist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-12-03 |
1851861850 | Grace Blankenhagen | Physical Therapist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-12-03 |
1316429863 | Elizabeth Marie Teklinski | Counselor | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-08-31 |
1326544230 | Kaitlyn Troutman | Nurse Practitioner | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-04-02 |
1598267254 | Teresa Lynn Hearne | Physical Therapist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-03-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
Find all providers in zip 49686 |
Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144697848 | Matthew Burns Nielsen | Pharmacist | 1201a S Division St, Traverse City, MI 49684-4426 | 2015-08-28 |
1972924967 | Gregory James Baker | Pharmacist | 1020 Sixth Street, Traverse City, MI 49684 | 2013-12-18 |
1366796302 | Keith Patterson Jr. | Pharmacist | 125 E South Airport Rd, Pharmacy, Traverse City, MI 49686 | 2012-10-30 |
1386910446 | Mark R Suitor | Pharmacist | 4144 Us Highway 31 S, Traverse City, MI 49685-9228 | 2012-03-22 |
1679858393 | Robert Bradshaw | Pharmacist | 2350 Us 31 N, Traverse City, MI 49686-3756 | 2011-10-13 |
1619251394 | Camilla Williams | Pharmacist | 4122 Us Highway 31 S, Traverse City, MI 49685-9228 | 2011-09-29 |
1275815797 | David L Pontious | Pharmacist | 1029 M 37 S, Traverse City, MI 49685-8508 | 2011-09-10 |
1316227895 | Matthew Born | Pharmacist | 3900 N Us 31 S, Traverse City, MI 49684-4447 | 2011-08-28 |
1285925180 | Robert Brzezinski | Pharmacist | 1201a S Division, Traverse City, MI 49684 | 2011-04-26 |
1689965634 | Marie Kristin Sweet | Pharmacist | 1201 A S Division, Traverse City, MI 49684 | 2011-04-26 |
Find all providers in TRAVERSE CITY |
City | TRAVERSE CITY |
Zip Code | 49686 |
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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.