JESSICA SHANTZ


Address: 28800 Ryan Rd Ste 320, Warren, MI 48092-4272
Phone: 5865820500

JESSICA SHANTZ (NPI# 1790255248) 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) 1790255248
Entity Type Individual
Full Name JESSICA SHANTZ
Credential PMHNP
Practice Address 28800 Ryan Rd Ste 320
Warren
MI 48092-4272
Mailing Address 26029 Continental Cir
Taylor
MI 48180-6900
Practice Telephone 5865820500
Practice Fax Number 5868342231
Mailing Telephone 7348915046
Enumeration Date 2018-11-27
Last Update Date 2018-11-27
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
4704267746 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 28800 RYAN RD STE 320
City WARREN
State MI
Zip Code 48092-4272

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699012229 Lynne Strachan Physician Assistant 28800 Ryan Rd Ste 320, Warren, MI 48092-4269 2013-01-16
1710549571 Kaitlyn Marie Barner Social Worker 28800 Ryan Rd Ste 320, Warren, MI 48092-4272 2019-07-02
1255844023 Letricia Lenise Clark Nurse Practitioner 28800 Ryan Rd Ste 320, Warren, MI 48092-4272 2017-11-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1881163186 Katherine Byrd Behavior Technician 3691 East 11 Mile Rd., Warren, MI 48092 2018-11-15
1861980302 Mark Paul Azzo Home Health Aide 27605 Walker Ave, Warren, MI 48092 2018-04-30
1144747130 Joseph Galutan Estrada Chiropractor 4846 Marlow Dr, Warren, MI 48092 2017-08-29
1649669425 Lawrence Mosurak IIi Chiropractor 6201 Chicago Road, Warren, MI 48092 2015-01-15
1174911713 Kimberly A Ott Nurse Practitioner 28800 Ryan Rd Suite 320, Warren, MI 48092 2015-01-06
1487071999 Michele Szandzik Chiropractor 2243 East 12 Mile Rd, Warren, MI 48092 2014-03-21
1962827311 Mouradian Dental Center, D.d.s., P.C. Dentist 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 2014-02-21
1639495930 Debra Kay Wenneman Physical Therapist 28776 Ryan Rd, Warren, MI 48092 2010-04-12
1922332923 Sonia Amirali Pethani Physical Therapist 2117 E. Eleven Mile Rd., Warren, MI 48092 2009-09-23
1881822237 Michael Patrick Walsh Orthopaedic Surgery 28800 Ryan Rd Ste 310, Warren, MI 48092 2009-06-24
Find all providers in zip 48092

Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750992319 Katherine Elizabeth Loffredo Nurse Practitioner 74 Seymour St, Warren, RI 02885-4227 2020-08-16
1306455860 Wendy Michelle Ray Nurse Practitioner 1012 E Church St Ste A, Warren, AR 71671-3530 2020-07-29
1124679725 Aprille Palac Mangalonzo Nurse Practitioner 14 Hillcrest Blvd, Warren, NJ 07059-5116 2019-09-25
1831505577 Mary Grace Hall Nurse Practitioner 103 W Market St, Warren, OH 44481-1017 2014-07-02
1114548468 Karen Marie Kline Nurse Practitioner 514 W 3rd Ave, Warren, PA 16365-2245 2020-04-28
1891321428 Brandi Kaufman Nurse Practitioner 8577 E Market St, Warren, OH 44484-2345 2020-03-16
1720620198 Elizabeth Miller Nurse Practitioner 150 E Market St, Warren, OH 44481-1141 2019-10-17
1538712922 Zach Aldridge Nurse Practitioner 150 E Market St, Warren, OH 44481-1141 2019-07-24
1396202412 Tammy A Klinefelter Nurse Practitioner 3120 W Market St, Warren, OH 44485-3069 2019-02-25
1255844023 Letricia Lenise Clark Nurse Practitioner 28800 Ryan Rd Ste 320, Warren, MI 48092-4272 2017-11-14
Find all providers in WARREN

Competitor

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City WARREN
Zip Code 48092

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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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