BIANCA GREEN (NPI# 1154872190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154872190 |
| Entity Type | Individual |
| Full Name | BIANCA GREEN |
| Other Name | BIANCA ZDENEK |
| Credential | NP |
| Practice Address |
5701 Bow Pointe Dr Clarkston MI 48346-3198 |
| Mailing Address |
2561 Elizabeth Lake Rd Waterford MI 48328-3313 |
| Practice Telephone | 2486252621 |
| Practice Fax Number | 2486252621 |
| Mailing Telephone | 2486823300 |
| Mailing Fax Number | 2486820026 |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2017-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704292920 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5701 BOW POINTE DR |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48346-3198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417955246 | James A Oneill | Pediatrics | 5701 Bow Pointe Dr, Suite 100, Clarkston, MI 48346-3198 | 2005-07-14 |
| 1437504149 | Sara Michelle Lebovic | Advanced Practice Midwife | 5701 Bow Pointe Dr, Suite 350, Clarkston, MI 48346-3198 | 2016-05-01 |
| 1649643263 | Michael Engler | Physician Assistant | 5701 Bow Pointe Dr, Clarkston, MI 48346-3198 | 2015-11-04 |
| 1285000869 | Sandra Aloia | Nurse Practitioner | 5701 Bow Pointe Dr, Ste 370, Clarkston, MI 48346 | 2015-08-18 |
| 1245621804 | Rochester Knee & Sports Medicine PC | Durable Medical Equipment & Medical Supplies | 5701 Bow Pointe Dr, Suite 300, Clarkston, MI 48346-3198 | 2015-02-18 |
| 1316371271 | Arli Susan Motsinger | Nurse Practitioner | 5701 Bow Pointe Dr, Suite100, Clarkston, MI 48346-3198 | 2013-08-28 |
| 1609200021 | Scott Walter Tycholiz | Physician Assistant | 5701 Bow Pointe Dr, Suite 120, Clarkston, MI 48346-3198 | 2013-08-22 |
| 1710239652 | Rebecca Lynn Warner | Physical Therapist | 5701 Bow Pointe Dr, Ste 300, Clarkston, MI 48346-3198 | 2012-10-02 |
| 1811262546 | Bradley Wallace Erlandson Sr. | Counselor | 5701 Bow Pointe Dr, Clarkston, MI 48346-3198 | 2012-03-13 |
| 1043525025 | Susan Louise Clark | Nurse Practitioner | 5701 Bow Pointe Dr, Suite 225, Clarkston, MI 48346-3198 | 2010-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399745 | Therapy Services of Clarkston LLC | Clinic/Center | 6770 Dixie Highway, Suite 103, Clarkston, MI 48346 | 2019-10-30 |
| 1679041545 | Shiba Lashon Nixon | Registered Nurse | New Oakland, 6549 Town Center Suite A, Clarkston, MI 48346 | 2018-11-08 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1558880591 | 3rd Circle Inc. | Home Health Aide | 39 South Main Street, Ste 2, Clarkston, MI 48346 | 2017-09-11 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1649635087 | Coddaire & Associates, Inc. | Community/Behavioral Health | 6445 Citation Drive, Suite H, Clarkston, MI 48346 | 2015-12-30 |
| 1013386358 | Victoria Urikh-garcia | Technician, Other | 6510 Town Center Dr Ste E, Clarkston, MI 48346 | 2015-09-16 |
| 1194090993 | Stefanie Pavloski | Counselor | 5701 Bow Pointe Dr., Ste. #380, Clarkston, MI 48346 | 2012-03-13 |
| Find all providers in zip 48346 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033767223 | William Bodnar | Nurse Practitioner | 3701 College Ave, Clarkston, GA 30021-2508 | 2019-08-30 |
| 1619537636 | Samina A. Damani | Nurse Practitioner | 3700 Market St Ste E, Clarkston, GA 30021-2600 | 2019-06-20 |
| 1457911281 | Megan Clemence | Nurse Practitioner | 7210 N Main St Ste 200, Clarkston, MI 48346-1575 | 2019-06-14 |
| 1821577479 | Jerrica Kallio | Nurse Practitioner | 909 Verdi Way, Clarkston, GA 30021-1057 | 2018-08-13 |
| 1346731866 | Wanda M Lewis | Nurse Practitioner | 10112 Windy Knoll Ct, Clarkston, MI 48348-2182 | 2018-05-21 |
| 1104334846 | Tiffany Johnson | Nurse Practitioner | 1040 Noble Vines Dr Apt 2, Clarkston, GA 30021-1345 | 2018-01-16 |
| 1720596802 | Kenzie Gardner | Nurse Practitioner | 7643 Olde Sturbridge Trl, Clarkston, MI 48348-4613 | 2018-01-11 |
| 1245767631 | Eric Dudenhofer Arnp Ps | Nurse Practitioner | 1271 Highland Ave # B, Clarkston, WA 99403-2846 | 2017-05-16 |
| 1710343181 | Teri Massey | Nurse Practitioner | 518 Sunrise Dr, Clarkston, MI 48348-1493 | 2016-01-14 |
| 1275998833 | Joyce John | Nurse Practitioner | 4378 Bluff Pointe, Clarkston, MI 48348-5081 | 2015-12-28 |
| Find all providers in CLARKSTON | ||||
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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.