MRS. STEPHANIE C MULLENNIX (NPI# 1134773468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134773468 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANIE C MULLENNIX |
| Credential | RN, CEN, AGCNS-BC |
| Practice Address |
4100 Embassy Dr Se Ste 400 Grand Rapids MI 49546-2416 |
| Mailing Address |
8938 Cottonwood Dr Jenison MI 49428-9510 |
| Practice Telephone | 6169888233 |
| Practice Fax Number | 6169573320 |
| Mailing Telephone | 6163250069 |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | 4704230534 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4100 EMBASSY DR SE STE 400 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-2416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538687215 | Sonia Nicola | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2017-09-01 |
| 1285109256 | Brittne Heidelberg | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2018-10-05 |
| 1194203240 | Rebecca Marie Cline | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2018-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750934451 | Chad R Galdys | Clinical Nurse Specialist | 251 Michigan St Ne # Mc018, Grand Rapids, MI 49503-2531 | 2019-07-22 |
| 1255983136 | Ashley Perkins | Clinical Nurse Specialist | 100 Michigan St Ne # Mc191, Grand Rapids, MI 49503-2560 | 2019-07-11 |
| 1609480219 | Amanda L Tomes | Clinical Nurse Specialist | 230 Michigan St Ne, Grand Rapids, MI 49503-2550 | 2020-09-01 |
| 1144873845 | Lisa Joy Mccann-spry | Clinical Nurse Specialist | 1840 Wealthy St Se, Grand Rapids, MI 49506-2921 | 2019-07-22 |
| 1578116273 | Lynn Vanregenmorter | Clinical Nurse Specialist | 100 Michigan St Ne, Grand Rapids, MI 49503-2560 | 2019-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850136 | Jennifer Vincent | Clinical Nurse Specialist | 1215 E Michigan Ave, Lansing, MI 48912-1896 | 2020-10-30 |
| 1790391092 | Ashley Voss | Clinical Nurse Specialist | 205 N East Ave, Jackson, MI 49201-1753 | 2020-09-22 |
| 1184230054 | Ashley Stoeckle | Clinical Nurse Specialist | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-09-16 |
| 1689204380 | Sherry Lynn Werth | Clinical Nurse Specialist | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-01-22 |
| 1083263008 | Rachel Justice | Clinical Nurse Specialist | 1215 E Michigan Ave, Lansing, MI 48912-1896 | 2019-09-11 |
| 1215580303 | Kaylin Hurlburt | Clinical Nurse Specialist | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2019-07-18 |
| 1396397089 | Laura Cook | Clinical Nurse Specialist | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2019-07-12 |
| 1134682883 | Michelle Ann Crean | Clinical Nurse Specialist | 1900 Columbus Ave, Bay City, MI 48708-6831 | 2019-04-10 |
| 1275018533 | Shannon Joy Behling | Clinical Nurse Specialist | 605 Oak St, Big Rapids, MI 49307-2048 | 2018-10-02 |
| 1518443514 | Jennifer Watkins | Clinical Nurse Specialist | 1140 E Michigan Ave Ste 400, Lansing, MI 48912-1806 | 2018-07-13 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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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.