SHOBA SOSALE-BERKUCHEL RYAN (NPI# 1730539149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730539149 |
| Entity Type | Individual |
| Full Name | SHOBA SOSALE-BERKUCHEL RYAN |
| Credential | DNP, PMHNP-BC |
| Practice Address |
1105 Sixth St Traverse City MI 49684-2345 |
| Practice Telephone | 2319355000 |
| Mailing Telephone | 2319355000 |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2019-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704276281 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1105 SIXTH ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364315 | Kersti Bruining | Specialist | 1105 Sixth St, Traverse City, MI 49684-2345 | 2005-05-24 |
| 1366060949 | Jillian Kordecki Finn | Student in an Organized Health Care Education/Training Program | 1105 Sixth St, Traverse City, MI 49684-2345 | 2020-07-09 |
| 1457998163 | Michele Marie Pupel | Registered Nurse | 1105 Sixth St, Traverse City, MI 49684-2386 | 2019-12-02 |
| 1205473956 | Dawn Elizabeth Gilbert | Health Educator | 1105 Sixth St, Traverse City, MI 49684-2386 | 2019-12-02 |
| 1376196519 | Erin Elizabeth Ackley | Speech-Language Pathologist | 1105 Sixth St, Traverse City, MI 49684-2345 | 2019-07-17 |
| 1174185938 | Shelly Drew | Speech-Language Pathologist | 1105 Sixth St, Traverse City, MI 49684-2386 | 2019-07-02 |
| 1144881863 | Rebecca Jan Nies | Speech-Language Pathologist | 1105 Sixth St, Traverse City, MI 49684-2386 | 2019-06-24 |
| 1336704139 | Anna O'connell | Nurse Practitioner | 1105 Sixth St, Traverse City, MI 49684-2345 | 2019-05-07 |
| 1619532900 | Brittany Miller | Dietitian, Registered | 1105 Sixth St, Traverse City, MI 49684-2345 | 2019-05-02 |
| 1649735226 | Morgan Kelsey Olson | Physician Assistant | 1105 Sixth St, Traverse City, MI 49684-2345 | 2019-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235695651 | Faith Jessica Huyck | Nurse Practitioner | 1050 Silver Dr, Traverse City, MI 49684-5749 | 2019-02-11 |
| 1336113216 | Tamlynn Evans | Nurse Practitioner | 401 W Front St, Suite 8, Traverse City, MI 49684-2259 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692494 | Memphis Chardell Sandoval | Nurse Practitioner | 131 S. Seaway Dr., Muskegon, MI 49441 | 2020-09-01 |
| 1588282784 | Mary Tackbary | Nurse Practitioner | 3932 W Briar Hill Dr, Maple City, MI 49664-9521 | 2020-07-14 |
| 1962032227 | Westlake Consultation Center | Nurse Practitioner | 4870 W Clark Rd Ste 100, Ypsilanti, MI 48197-1104 | 2020-01-24 |
| 1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
| 1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
| 1396289120 | Next Level Up Health & Wellness Inc. | Nurse Practitioner | 28423 Parkwood St, Inkster, MI 48141-1669 | 2016-12-13 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.