HOLLY LYNN GROTELUSCHEN (NPI# 1104449149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104449149 |
| Entity Type | Individual |
| Full Name | HOLLY LYNN GROTELUSCHEN |
| Credential | MD |
| Practice Address |
2510 Bellevue Medical Center Dr Ste 200 Bellevue NE 68123-1520 |
| Practice Telephone | 4025952275 |
| Mailing Telephone | 4025952275 |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2020-05-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2510 BELLEVUE MEDICAL CENTER DR STE 200 |
| City | BELLEVUE |
| State | NE |
| Zip Code | 68123-1520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073599890 | Jeremy C King | Family Medicine | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2005-12-22 |
| 1750996831 | Hillary Suzanne Stark | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2020-09-15 |
| 1306484944 | Kayla Renee Hergert | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2019-12-13 |
| 1891342671 | Nancy L Childe | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2019-08-26 |
| 1295203701 | Allison Cox | Physician Assistant | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2018-11-02 |
| 1255817367 | Christabel Orobosa Alphonso | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2018-07-12 |
| 1770075129 | Jamie Michelle Shaw | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2018-06-01 |
| 1952815920 | Alix Sandbothe | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2017-11-28 |
| 1639555279 | Shelley C Booth | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2015-08-05 |
| 1629461280 | Katie Jo Kmiecik | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123 | 2015-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482227 | Gloria Pettigrew-fletcher | Community Health Worker | 12432 A 36th St, C20, Bellevue, NE 68123 | 2020-03-13 |
| 1225480676 | Heidi Jean Mccoy | Dentist | 2110 Towne Centre Drive, Bellevue, NE 68123 | 2016-07-11 |
| 1538557442 | Mariam Abdelghany I | Physician Assistant | 2500 Bellevue Medical Center Drive, Bellevue, NE 68123 | 2014-12-30 |
| 1205243367 | Sara Johnson | Pharmacist | 3614 Twin Creeks Drive, Bellevue, NE 68123 | 2014-07-21 |
| 1174826747 | Francine Amy Drummond | Dentist | 1701 Independence Lane #22, Bellevue, NE 68123 | 2010-12-21 |
| 1053509588 | Dunlow Orthodontics, P.C. | Dentist | 2219 Capehart Road, Suite 102, Bellevue, NE 68123 | 2007-10-10 |
| 1801911870 | Michelle Lynn Gaeth | Dentist | 11536 S. 31st St., Bellevue, NE 68123 | 2007-03-20 |
| 1386789832 | Mary Monique Rotert | Psychologist | 3308 Samson Way Road, Suite 211, Bellevue, NE 68123 | 2007-02-21 |
| 1316084098 | Kevin B Jones | Family Medicine | 3308 Samson Way Ste 102, Bellevue, NE 68123 | 2007-01-31 |
| 1467529727 | Nebraska Medical Center | Pharmacy | 2510 Bellevue Medical Center Drive, Suite 100, Bellevue, NE 68123 | 2006-11-29 |
| Find all providers in zip 68123 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033724968 | Julia Yunkyung Yi | Student in an Organized Health Care Education/Training Program | 527 Bellevue Way Se Apt 203, Bellevue, WA 98004-6684 | 2020-09-08 |
| 1366055113 | Diana Spann | Student in an Organized Health Care Education/Training Program | 702 141st Ln Se, Bellevue, WA 98007-6764 | 2020-08-30 |
| 1558986356 | Malika Jhawar | Student in an Organized Health Care Education/Training Program | 5613 167th Pl Se, Bellevue, WA 98006-5543 | 2020-06-08 |
| 1760020341 | Ismael Chaparro De La O | Student in an Organized Health Care Education/Training Program | 1004 Kauii Dr, Bellevue, NE 68005-4135 | 2019-12-14 |
| 1528590791 | Jennifer Moon | Student in an Organized Health Care Education/Training Program | 2308 128th Ave Se, Bellevue, WA 98005-4238 | 2017-03-28 |
| 1952751836 | Mona Ebrahimi | Student in an Organized Health Care Education/Training Program | 14270 Ne 21st, Rainbow Creek, Bellevue, WA 98007 | 2016-06-21 |
| 1578939302 | Walgreen | Student in an Organized Health Care Education/Training Program | 15220 156th Ne, Bellevue, WA 98007 | 2015-08-17 |
| 1891172409 | Nicholas Michael | Student in an Organized Health Care Education/Training Program | 3500 Factoria Blvd Se, Bellevue, WA 98006-5276 | 2015-05-04 |
| 1427466580 | Katherine Emily White | Student in an Organized Health Care Education/Training Program | 15031 Se 65th St, Bellevue, WA 98006-5015 | 2014-07-31 |
| 1265856041 | Beau Frederick Mar Chiba | Student in an Organized Health Care Education/Training Program | 6140 156th Pl Se, Bellevue, WA 98006-5308 | 2014-02-13 |
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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.