JISHA DUDEESH (NPI# 1902356272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902356272 |
| Entity Type | Individual |
| Full Name | JISHA DUDEESH |
| Credential | NP |
| Practice Address |
22151 Moross Rd Professional Building One Detroit MI 48236-2167 |
| Practice Telephone | 3133437107 |
| Mailing Telephone | 3133437107 |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2018-11-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 4704256647 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704256647 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6777 W Maple Rd, West Bloomfield, MI 483223013 | 3136221380 | 3136221380 |
| Street Address |
22151 MOROSS RD PROFESSIONAL BUILDING ONE |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440463 | Christine Ann Crader | Internal Medicine | 22151 Moross Rd, Detroit, MI 48236-2167 | 2005-07-12 |
| 1467078857 | Anirudh Kotha | Student in an Organized Health Care Education/Training Program | 22151 Moross Rd, Ste 214, Detroit, MI 48236 | 2020-06-22 |
| 1386147981 | Carla Freigeh | Physician Assistant | 22151 Moross Rd, Detroit, MI 48236-2167 | 2018-03-10 |
| 1245738822 | Stacey Alise Joiner | Counselor | 22151 Moross Rd, Detroit, MI 48236-2167 | 2018-01-29 |
| 1730618158 | Victoria Elizabeth Simmons | Surgery | 22151 Moross Rd, Suite 214, Detroit, MI 48236 | 2017-06-08 |
| 1841740792 | Celia Shallal | Social Worker | 22151 Moross Rd, Pb1, Detroit, MI 48236-2167 | 2016-10-04 |
| 1841668308 | Moayad Tarboush | Student in an Organized Health Care Education/Training Program | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-09-14 |
| 1285023226 | Lauren Krist | Nurse Practitioner | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-01-14 |
| 1194122937 | Patricia Vassallo | Nurse Practitioner | 22151 Moross Rd, Pb 2 Suite 209, Detroit, MI 48236-2167 | 2014-11-21 |
| 1861736431 | Amer Abdul-hafiz Afaneh | Surgery | 22151 Moross Rd, Suite 212, Detroit, MI 48236-2167 | 2012-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326475757 | Patrice Wade-olson | Nurse Practitioner | 4201 St. Antione Uhc 5f, University Pediatricians, Detroit, MI 48201 | 2013-09-30 |
| 1073633913 | Joyce Elizabeth Grimm | Nurse Practitioner | 2567 W Grand Blvd, Detroit, MI 48208-1235 | 2007-03-31 |
| 1295842011 | Yvonne M Taylor | Nurse Practitioner | 4303 Woodhall St, Detroit, MI 48224-2222 | 2006-08-25 |
| 1336637008 | Natalie Blonski | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202 | 2018-04-27 |
| 1457849283 | Toyia Lenise Straughter | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2018-04-26 |
| 1912408915 | Yaukpala Ina Gofan | Nurse Practitioner | 4100 John R St, Detroit, MI 48201-2013 | 2018-02-24 |
| 1194263012 | Reema Rahal | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2017-02-11 |
| 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 |
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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.