MRS. KIMBERLY T CANTILLON (NPI# 1740218999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740218999 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY T CANTILLON |
| Other Name | MISS KIMBERLY T WILSON |
| Credential | PA |
| Practice Address |
1036 E Grand River Ave Brighton MI 48116-1806 |
| Practice Telephone | 8102271540 |
| Mailing Telephone | 8102271540 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601004760 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE | 5301004760 | 01 |
| Street Address |
1036 E GRAND RIVER AVE |
| City | BRIGHTON |
| State | MI |
| Zip Code | 48116-1806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972598282 | Lawrence Howard Lafond | Family Medicine | 1036 E Grand River Ave, Brighton, MI 48116-1806 | 2005-09-13 |
| 1033328299 | Lafond Medical P C | Family Medicine | 1036 E Grand River Ave, Brighton, MI 48116-1806 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134686470 | Kristen Marie Ora | Social Worker | 8548 Grand River, Brighton, MI 48116 | 2019-02-22 |
| 1861981839 | Root To Rise Pllc | Social Worker | 396 Woodlake Dr, Brighton, MI 48116 | 2018-05-06 |
| 1952852857 | Valley Medical Pharmacy LLC | Pharmacy | 320 W Grand River Ave, Brighton, MI 48116 | 2016-10-17 |
| 1619360047 | Reema S Beri | Psychologist | 10327 East Grand River Avenue, Suite 406, Brighton, MI 48116 | 2015-03-10 |
| 1669883872 | Holly Babcock | Pharmacist | 8650 W Grand River, Brighton, MI 48116 | 2014-05-12 |
| 1861803991 | Corrigan Counseling Plc | Community/Behavioral Health | 710 E. Grand River Ave, Suite 2, Brighton, MI 48116 | 2014-05-12 |
| 1760756274 | Karen Joan Bergbower | Social Worker | 10299 Grand River, Suite P, Brighton, MI 48116 | 2012-03-01 |
| 1518298843 | Adam N Rushford | Chiropractor | 10192 E Grand River, Suite 107, Brighton, MI 48116 | 2010-01-27 |
| 1548419617 | Doreen Csokasy | Psychologist | 10315 E. Grand River, Brighton, MI 48116 | 2008-09-15 |
| 1336314350 | Larry Patrick Dewulf | Dentist | 8609 W Grand River, #102-1, Brighton, MI 48116 | 2008-04-30 |
| Find all providers in zip 48116 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326596396 | Constantina Kostka | Physician Assistant | 1560 Commonwealth Ave, Apt. #16, Brighton, MA 02135-5038 | 2016-09-19 |
| 1689919318 | Alexis Grant Kochevar | Physician Assistant | 70 S 20th Ave Ste H, Brighton, CO 80601-3704 | 2012-12-06 |
| 1851529978 | Mark Brian Mcintee | Physician Assistant | 7575 W. Grand River, Brighton, MI 48114 | 2009-06-26 |
| 1154804847 | Rebecca Lynn Kahn | Physician Assistant | 8273 Grand River Rd Ste 210, Brighton, MI 48114-9346 | 2018-09-10 |
| 1831695634 | Amanda Dvorak | Physician Assistant | 2801 Purcell St, Brighton, CO 80601 | 2018-04-02 |
| 1942759998 | Stephen Norris Pope-rolewski | Physician Assistant | 2801 Purcell St, Brighton, CO 80601-3551 | 2016-09-30 |
| 1780032524 | Alyssa Zantello | Physician Assistant | 2305 Genoa Business Park Dr, Suite 170, Brighton, MI 48114-7004 | 2016-06-02 |
| 1689070963 | Shawna Karman | Physician Assistant | 2801 Purcell St, Brighton, CO 80601-3551 | 2014-11-13 |
| 1013324367 | Lane Marie Bryant | Physician Assistant | 1860 E Egbert St, Brighton, CO 80601-2475 | 2014-07-18 |
| 1083902811 | Lindsay C. Stanley | Physician Assistant | 736 Cambridge St, Brighton, MA 02135-2907 | 2011-07-14 |
| Find all providers in BRIGHTON | ||||
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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.