NICOLE SHELLENBARGER


Address: 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816
Phone: 6162677333

NICOLE SHELLENBARGER (NPI# 1780080762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780080762
Entity Type Individual
Full Name NICOLE SHELLENBARGER
Credential PA
Practice Address 4069 Lake Dr Se Ste 313
Grand Rapids
MI 49546-8816
Mailing Address 100 Michigan St Ne # Mc845
Grand Rapids
MI 49503-2560
Practice Telephone 6162677333
Mailing Telephone 6164866790
Enumeration Date 2014-11-18
Last Update Date 2017-10-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4069 LAKE DR SE STE 313
City GRAND RAPIDS
State MI
Zip Code 49546-8816

Providers in the same location

NPI Name Taxonomy Address Enumeration
1093755092 Richard Kahnoski Urology 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816 2006-06-07
1508352832 Allison Margaret Toth Nurse Practitioner 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816 2018-07-10
1497110852 Ashley Lynn Schmidt Physician Assistant 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816 2015-12-29
1366853293 Conrad Maxwell Tobert Urology 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816 2014-05-14
1528403235 George Michael Ghareeb Urology 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816 2013-05-08
1568662112 Michael Jon Lyons Physician Assistant 4069 Lake Dr Se Ste 313, Grand Rapids, MI 49546-8816 2007-07-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437762986 Amanda Mae Ostrom Speech-Language Pathologist 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 2020-08-25
1063075562 Kelly Lynn Ibarra Counselor 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 2019-04-19
1891257036 Jessica Matthews LLC Counselor 4127 Embassy Drive Se, Grand Rapids, MI 49546 2019-04-05
1326518531 Neah Morgan Technician 4220 Burton St Se, Grand Rapids, MI 49546 2018-11-29
1316430267 Michael John Benskey Case Manager/Care Coordinator 4065 Saladin St Se, Grand Rapids, MI 49546 2018-06-14
1679062772 Smile Cascade, P.C. Clinic/Center 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 2018-05-03
1720583289 Jeromy Krogman Counselor 826 Parchment Drive Se, Grand Rapids, MI 49546 2018-03-27
1841792660 Affordable Hearing Clinic Hearing Instrument Specialist 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 2018-03-07
1689176133 Kelly Pines Physical Therapist 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 2018-03-01
1467971440 Deanna Elizabeth Saenz Social Worker 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 2017-09-12
Find all providers in zip 49546

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609473198 Rachel M. Graziano Physician Assistant 18 Lowell Ave Ne, Grand Rapids, MI 49503-3760 2020-10-07
1811537269 Joseph Salvatore Giovannucci Physician Assistant 145 Michigan St Ne Ste 2230, Grand Rapids, MI 49503-2562 2020-01-14
1326685686 Mitchell Lebel Physician Assistant 932 Fulton St E Unit 1, Grand Rapids, MI 49503-3565 2019-12-05
1326680331 Emily Wallace Physician Assistant 1661 Philadelphia Ave Se, Grand Rapids, MI 49507-2251 2019-10-10
1124688197 Leeann Marie Kuehn Physician Assistant 218 Warren Ave Se, Grand Rapids, MI 49506-1582 2019-06-20
1770057549 Shelby Elizabeth Hunt Physician Assistant 100 Michigan St Ne # Mc9017, Grand Rapids, MI 49503-2560 2019-01-15
1063906865 Kimberly Eccher Physician Assistant 300 68th St. Se, Grand Rapids, MI 49548 2018-06-15
1174029094 Katrina Ann Brummel Physician Assistant 555 Midtowne St Ne Ste 110, Grand Rapids, MI 49503-5731 2018-03-30
1902312994 Aaron Michaud Physician Assistant 301 Barclay Ave Ne, Grand Rapids, MI 49503 2017-12-28
1538687215 Sonia Nicola Physician Assistant 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 2017-09-01
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 49546

Improve Information

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Dataset Information

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.

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