DR. KHIANA KEREN WILLIS (NPI# 1720311319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720311319 |
Entity Type | Individual |
Full Name | DR. KHIANA KEREN WILLIS |
Credential | PHARMD |
Practice Address |
4646 John R St Detroit Vamc Outpatient Pharmacy Detroit MI 48201-1916 |
Mailing Address |
25711 Lyndon Redford MI 48239-3340 |
Practice Telephone | 3135761000 |
Mailing Telephone | 3135875755 |
Enumeration Date | 2009-09-14 |
Last Update Date | 2012-11-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 183500000X | Pharmacist | 19394 | MD | Pharmacy Service Providers |
Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
5302040102 | MI | Pharmacy Service Providers |
Street Address |
4646 JOHN R ST DETROIT VAMC OUTPATIENT PHARMACY |
City | DETROIT |
State | MI |
Zip Code | 48201-1916 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356344121 | Christopher Emil Hermann | Nurse Practitioner | 4646 John R St, Detroit, MI 48201-1916 | 2005-05-24 |
1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
1598371544 | Sonia Govil | Dietitian, Registered | 4646 John R St, Detroit, MI 48201-1916 | 2020-09-16 |
1740893569 | Nicholas Edward Peters | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-31 |
1710597455 | Amber Michelle Young | Social Worker | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-07 |
1104434471 | Zeinab H Moussa | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-22 |
1235747346 | Samantha Beth Lewis | Psychologist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-15 |
1477171189 | Rima Mohammad Fardos | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-09 |
1992323869 | Sarah F Waqhar | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-08 |
1619594181 | Mellisa Ann Boyle | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
Find all providers in zip 48201 |
Taxonomy Code | 1835P0018X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265099600 | Isidro II Inc | Pharmacist | 10809 Mack Ave, Detroit, MI 48214-2119 | 2019-05-21 |
1639637135 | Bassam Harati | Pharmacist | 14470 Livernois Ave, Detroit, MI 48238-2005 | 2019-03-04 |
1336626654 | Kyle Weslosky | Pharmacist | 4646 John R Road, Detroit, MI 48201 | 2018-07-20 |
1174009872 | Lauren Depietro | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2018-07-16 |
1346619772 | Kelly Saha | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2015-09-16 |
1477938538 | Ryan Timothy Kuhn | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2015-07-29 |
1023417490 | John Dilodovico | Pharmacist | 2799 W Grand Blvd, W-1018, Detroit, MI 48202-2608 | 2014-08-21 |
1972902443 | Amber Lanae Smith | Pharmacist | 259 Mack Ave, Detroit, MI 48201-2427 | 2014-08-20 |
1447688155 | Arin Jantz | Pharmacist | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2013-10-16 |
1104252659 | Trisann Rendulic | Pharmacist | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2013-09-16 |
Find all providers in DETROIT |
Please comment or provide details below to improve the information on DR. KHIANA KEREN WILLIS.
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.