ETHAN PRESTON (NPI# 1982191169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982191169 |
| Entity Type | Individual |
| Full Name | ETHAN PRESTON |
| Credential | FNP |
| Practice Address |
25990 Crocker Blvd Harrison Township MI 48045-3450 |
| Mailing Address |
1279 Harpst St Ann Arbor MI 48104-6131 |
| Practice Telephone | 5864655501 |
| Mailing Telephone | 3136836981 |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704266333 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306498134 | Ethan G Preston | Counselor | 700 Park Ave, Ironton, OH 45638-1502 | 2019-07-11 |
| Street Address |
25990 CROCKER BLVD |
| City | HARRISON TOWNSHIP |
| State | MI |
| Zip Code | 48045-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477503217 | Michael Valentine Kurzawa | Family Medicine | 25990 Crocker Blvd, Harrison Township, MI 48045-3450 | 2006-05-11 |
| 1629570254 | Gloria J Severini | Physical Therapist | 25990 Crocker Blvd, Harrison Township, MI 48045-3450 | 2018-02-28 |
| 1306345756 | Amy Errer | Physical Medicine & Rehabilitation | 25990 Crocker Blvd, Harrison Township, MI 48045-3450 | 2018-02-12 |
| 1518466630 | Kusum Bhana | Occupational Therapist | 25990 Crocker Blvd, Harrison Township, MI 48045-3450 | 2018-02-04 |
| 1851564538 | Susan V Phillips | Physical Therapist | 25990 Crocker Blvd, Harrison Township, MI 48045-3450 | 2008-04-02 |
| 1679589733 | Sean Michael Marshall | Physical Therapist | 25990 Crocker Blvd, Harrison Township, MI 48045-3450 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447602040 | Integrated Solution LLC | Social Worker | 24791 Parkside St., Apt. 206, Harrison Township, MI 48045 | 2016-07-07 |
| 1598908352 | Andrew Frank Langlois | Pharmacist | 28350 S.river Rd, Harrison Twp, MI 48045 | 2009-04-09 |
| 1629241559 | Brandon Charles Holda | Technician, Other | 43401 N. Jefferson Bldg #825, Selfridge Angb, MI 48045 | 2008-04-11 |
| 1902022601 | Detroit Uscg Phcy | Military/U.S. Coast Guard Pharmacy | 43355 North Jefferson, Uscg Clinic - Bldg 825, Detroit, MI 48045 | 2007-04-18 |
| 1477620755 | Uscg Clinic Sector Detroit | Clinic/Center | 43401 N. Jefferson, Bldg 825, Selfridge Angb, MI 48045 | 2006-11-29 |
| 1568561983 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 410 Mitchell, Selfridge Air Base, MI 48045 | 2006-09-22 |
| 1477661700 | Bridgeview Chiropractic Center | Chiropractor | 28326 S River Rd, Harrison Twp, MI 48045 | 2006-08-28 |
| 1851362586 | St. John Hospital and Medical Center | General Acute Care Hospital | 26755 Ballard Road, Harrison Township, MI 48045 | 2006-01-31 |
| 1013256296 | Mclaren Macomb | Emergency Medicine | 39833 Bridgeview St, Harrison Township, MI 48045 | 2013-02-07 |
| 1265467682 | Venkateswara Rao Malineni | Psychiatry & Neurology | 215 North Ave, St Joseph Specialty Hospital 215, Mt Clemens, MI 48045 | 2006-07-12 |
| Find all providers in zip 48045 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972339 | Zeinab Berjaoui | Nurse Practitioner | 11496 Newbern Dr, Warren, MI 48093-2613 | 2020-11-08 |
| 1134720899 | Whitney Ashton Mervau | Nurse Practitioner | 3836 Haven Hill Ln, Williamsburg, MI 49690-9536 | 2020-11-07 |
| 1063013837 | Amy Lynn Wadsworth | Nurse Practitioner | 9259 Chambord Dr, Ypsilanti, MI 48197-9281 | 2020-11-06 |
| 1821699844 | Michelle Daldine | Nurse Practitioner | 38481 Gail St, Clinton Township, MI 48036-1823 | 2020-11-05 |
| 1710588876 | Coty Cole | Nurse Practitioner | 2065 South Center Rd, Ste A, Burton, MI 48519 | 2020-11-05 |
| 1205437175 | Michelle Jo Whitesel | Nurse Practitioner | 5861 Shadow Pines Ct, Howell, MI 48843-7130 | 2020-11-05 |
| 1326649617 | Melinda Lee Hawley | Nurse Practitioner | 4019 Stark Dr, West Branch, MI 48661-9633 | 2020-11-04 |
| 1720689193 | Mohammed Louthfur Rahman | Nurse Practitioner | Hoover Internal Medicine Pllc, 2930 Holbrook St, Hamtramck, MI 48212 | 2020-11-03 |
| 1619578234 | Devon Kruger | Nurse Practitioner | 4612 W David Hwy, Saranac, MI 48881-9740 | 2020-11-02 |
| 1760083208 | Ramonna Van Alstine | Nurse Practitioner | 13932 Fox Ridge Ln, Allenton, MI 48002-4525 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
| City | HARRISON TOWNSHIP |
| Zip Code | 48045 |
Please comment or provide details below to improve the information on ETHAN PRESTON.
| 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.