STEPHANIE DENISE SULEWSKI (NPI# 1114221439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114221439 |
| Entity Type | Individual |
| Full Name | STEPHANIE DENISE SULEWSKI |
| Credential | NCMA |
| Practice Address |
1063 Uss Tennessee Ave Avenue Ql 11 Kings Bay GA 31547-2606 |
| Mailing Address |
1025 Mad Fox Dr Jacksonville FL 32212-1124 |
| Practice Telephone | 2106510027 |
| Mailing Telephone | 8434417408 |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2010-12-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
616377 | TX | Other Service Providers |
| Street Address |
1063 USS TENNESSEE AVE AVENUE QL 11 |
| City | KINGS BAY |
| State | GA |
| Zip Code | 31547-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922316785 | D'metric Maudell Moss | Nurse's Aide | 881 Uss James Madison Raod, Naval Submarine Base, Kings Bay, GA 31547 | 2010-09-15 |
| 1023291788 | Jay D Carson | Military Health Care Provider | 1050 Uss Gerogia Ave, Kings Bay, GA 31547 | 2007-12-17 |
| 1568651321 | Westley Michael Durnell | Military Health Care Provider | 580 Uss Mariano G. Vallejo Ave, Nssc Medical, Kings Bay, GA 31547 | 2007-10-17 |
| 1013127497 | Cory Dean Sant | Military Health Care Provider | Uss Rhode Island Ssbn 740 (blue), 1059 Uss Georgia Ave, Kings Bay, GA 31547 | 2007-05-23 |
| 1982760492 | Rufus Benjamin Phillips | Pharmacist | Kingsbay Naval Base, Pharmacy, Kingsbay, GA 31547 | 2006-12-29 |
| 1083626949 | Michael Dennis Lappi | Preventive Medicine | Naval Branch Health Clinic Kings Bay, Kings Bay, GA 31547 | 2006-08-12 |
| 1578592838 | Eric Windsor Larson Sr. | Military Health Care Provider | 580 Uss Mariano G Vallejo Ave, Nssc Medical Kings Bay, Kings Bay, GA 31547 | 2006-06-30 |
| 1104894294 | Cary Grinold | Nurse Practitioner | 881 Uss James Madison Road, Naval Ambulatory Care Center, Kings Bay, GA 31547 | 2006-03-14 |
| 1144429507 | Tony Wayne Lyle | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547 | 2007-07-16 |
| 1801853874 | Barry Wayne Downing | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547 | 2006-04-26 |
| Find all providers in zip 31547 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003459942 | Summer Ann Felix | Military Health Care Provider | 4260 Nelson Hill Pl, Hahira, GA 31632-3264 | 2019-10-23 |
| 1811397243 | Kristy Luna | Military Health Care Provider | 2331 Downing Ave, Savannah, GA 31404-3953 | 2014-09-04 |
| 1952701641 | Alan Vega | Military Health Care Provider | 3715 N Valdosta Rd Apt 82, Valdosta, GA 31602 | 2014-08-29 |
| 1548697485 | John Dye Jr. | Military Health Care Provider | 655 Seventh St., Robins Afb, GA 31098 | 2013-10-10 |
| 1306189576 | Rebecca Lynne Lozano | Military Health Care Provider | 620 Randolph Ave, Warner Robins, GA 31098-1162 | 2013-04-05 |
| 1205110368 | Brian Russell Balcolm | Military Health Care Provider | 4099 Forrest Run Cir, Valdosta, GA 31605-6538 | 2011-10-06 |
| 1689957862 | Monique Nicole Toth | Military Health Care Provider | 3748 Robin Ln, Valdosta, GA 31605-5102 | 2011-09-23 |
| 1316230527 | Tamara Alisha Ivy | Military Health Care Provider | 138 Washington Ave, Waynesboro, GA 30830-8421 | 2011-05-20 |
| 1194033365 | Jessica Marie Barker | Military Health Care Provider | 317 Simms Rd, Carrollton, GA 30117-5611 | 2010-09-21 |
| 1346552783 | Bruchell Denise Washington | Military Health Care Provider | 4224 Wilshire Dr, Valdosta, GA 31605-7020 | 2010-07-13 |
| Find all providers with the same taxonomy | ||||
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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.