JUDY L JEROME (NPI# 1760433577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760433577 |
| Entity Type | Individual |
| Full Name | JUDY L JEROME |
| Credential | CGNP |
| Practice Address |
829 N Center Ave Suite 140 Gaylord MI 49735-1595 |
| Mailing Address |
310 N. Main Street Suite 301 Chelsea MI 48118-1807 |
| Practice Telephone | 9897317870 |
| Practice Fax Number | 9897317837 |
| Mailing Telephone | 7342228200 |
| Mailing Fax Number | 7342228202 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2017-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704120506 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TAX ID | 381303843 | 01 | |
| MI | 4874937 | 05 | |
| MI | MICHIGAN STATE LICENSE | 4704120506 | 01 |
| MI | DEA | MJ0967832 | 01 |
| Street Address |
829 N CENTER AVE SUITE 140 |
| City | GAYLORD |
| State | MI |
| Zip Code | 49735-1595 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598754715 | Luis Raul Collazo | Pediatrics | 829 N Center Ave, Suite 130, Gaylord, MI 49735-1595 | 2005-10-20 |
| 1174043889 | Michael D Katona | Nurse Practitioner | 829 N Center Ave, Gaylord, MI 49735-1595 | 2017-06-23 |
| 1114303575 | Brittanie Hamlin | Physician Assistant | 829 N Center Ave, Gaylord, MI 49735-1595 | 2015-08-07 |
| 1326443722 | Coleman Gulick | Nurse Practitioner | 829 N Center Ave, Gaylord, MI 49735-1595 | 2014-10-28 |
| 1720417694 | Kristy J. Alexander | Nurse Practitioner | 829 N Center Ave, Suite 200, Gaylord, MI 49735-1595 | 2013-11-01 |
| 1235401712 | John Matthew Lawrence | Physician Assistant | 829 N Center Ave, Suite 210, Gaylord, MI 49735-1595 | 2012-01-31 |
| 1043505399 | Yelena V Isayenko | Family Medicine | 829 N Center Ave, Suite 210, Gaylord, MI 49735-1595 | 2011-06-15 |
| 1598073801 | Shawn M Bahleda | Physician Assistant | 829 N Center Ave, Gaylord, MI 49735-1595 | 2010-09-21 |
| 1942511126 | Amanda Lee Williams | Pediatrics | 829 N Center Ave, Suite 130, Gaylord, MI 49735-1595 | 2010-06-23 |
| 1639301724 | Ronald Frank Applebey | Physician Assistant | 829 N Center Ave, Suite 210, Gaylord, MI 49735-1595 | 2009-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447453 | Jenni Kirt | Social Worker | 407 I-75 Bus N, Gaylord, MI 49735 | 2020-11-05 |
| 1922584986 | Patricia Dovalina | Behavior Technician | 2285 Michaywe Dr, Otsego Lake, MI 49735 | 2018-07-12 |
| 1265944581 | James Hulbert | Social Worker | 407 W Main Street, Gaylord, MI 49735 | 2017-10-26 |
| 1548792625 | Somer Lawes | Behavior Technician | 2443 Castlewood Dr, Gaylord, MI 49735 | 2017-03-29 |
| 1922554161 | Mark David Mcpherson | Counselor | 2136 West M-32, Gaylord, MI 49735 | 2016-08-28 |
| 1689063034 | Liza Brandt | Behavioral Analyst | 6748 Colonial Ct, Gaylord, MI 49735 | 2015-01-22 |
| 1942597224 | Visions for Your Community Care Hhc | Home Health | 2365 N Perch Lake Dr, Gaylord, MI 49735 | 2011-07-07 |
| 1073778304 | Julie Lynn Vandusen | Community Health Worker | 5512 Clubhouse Trail, Gaylord, MI 49735 | 2008-07-25 |
| 1073708798 | Alpine Chiropractic, PC | Chiropractor | 529 S. Wisconsin Ave, Gaylord, MI 49735 | 2007-09-06 |
| 1669675567 | Oral and Maxillofacial Surgery Associates | Dentist | 785 E M32, Gaylord, MI 49735 | 2007-06-07 |
| Find all providers in zip 49735 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518998772 | Mary B. Seger | Nurse Practitioner | 829 N Center Ave, Suite 140, Gaylord, MI 49735-1595 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942800768 | Yuri L Guzman | Nurse Practitioner | 795 N Ford Blvd, Ypsilanti, MI 48198-4116 | 2020-10-30 |
| 1144830803 | Robert Eugene Scribner IIi | Nurse Practitioner | 13913 Toepfer Rd, Warren, MI 48089-5842 | 2020-08-06 |
| 1124644661 | Denika Leflora Dalton | Nurse Practitioner | 5260 Fairway Trl, Grand Blanc, MI 48439-9445 | 2020-06-21 |
| 1780206995 | Jennifer Kay Marino | Nurse Practitioner | 20407 Mauer St, Saint Clair Shores, MI 48080-3789 | 2020-05-11 |
| 1720621709 | Kelsey Nicole Kloosterman | Nurse Practitioner | Susan P. Wheatlake Regional Cancer Center, 4499 220th Ave, Reed City, MI 49677 | 2019-10-23 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1306318498 | Ashley Marie Jacobson | Nurse Practitioner | 4100 Lake Dr Se Ste D, Grand Rapids, MI 49546-8292 | 2018-12-30 |
| 1568931673 | Jennifer Lavigne | Nurse Practitioner | 145 Michigan St Ne Ste 3300, Grand Rapids, MI 49503-2562 | 2018-11-19 |
| 1134694292 | Sheryl Ann Newton | Nurse Practitioner | 810 W South St, Kalamazoo, MI 49007-4601 | 2018-10-04 |
| 1386123180 | Alison M Sesock | Nurse Practitioner | 5202 Miller Rd Ste B, Flint, MI 48507-1040 | 2018-08-13 |
| Find all providers with the same taxonomy | ||||
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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.