JACQUELYN DUNN (NPI# 1154893956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154893956 |
| Entity Type | Individual |
| Full Name | JACQUELYN DUNN |
| Practice Address |
630 Kenmoor Ave Se Ste 102 Grand Rapids MI 49546-8626 |
| Mailing Address |
2527 Stockwood Dr Ne Grand Rapids MI 49505-3984 |
| Practice Telephone | 6169200825 |
| Mailing Telephone | 4199060470 |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704286714MOD170 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609213461 | Jacquelyn Rose Dunn | Internal Medicine | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2013-06-03 |
| Street Address |
630 KENMOOR AVE SE STE 102 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8626 |
| 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 | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558900183 | Kathryn Long | Nurse Practitioner | 1055 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2019-12-30 |
| 1134690761 | Koren Gebben | Nurse Practitioner | 1959 East Paris Ave Se, Grand Rapids, MI 49546-6272 | 2018-12-07 |
| 1841775483 | Stacy Lu Allen | Nurse Practitioner | 35 Michigan St Ne Ste 4150, Grand Rapids, MI 49503-2529 | 2018-09-29 |
| 1538654835 | Anna Marie Rykse | Nurse Practitioner | 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503 | 2018-06-28 |
| 1578065140 | Kallie Rae Kraker | Nurse Practitioner | 4118 Kalamazoo Ave Se, Grand Rapids, MI 49508-3605 | 2018-02-28 |
| 1083122790 | Christopher Michael Bouma | Nurse Practitioner | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2018-01-16 |
| 1144732850 | Michelle Kristine Buist | Nurse Practitioner | 35 Michigan St Ne, Grand Rapids, MI 49503-2514 | 2017-11-03 |
| 1952810830 | Kaitlin Jane Hendriksma | Nurse Practitioner | 550 Cherry St Se, Grand Rapids, MI 49503-4748 | 2017-09-24 |
| 1962954354 | Samantha Lynne Wylie | Nurse Practitioner | 35 Michigan St Ne Ste 3003, Grand Rapids, MI 49503-2528 | 2016-11-01 |
| 1881061497 | Carole Lenzo | Nurse Practitioner | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2015-08-31 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on JACQUELYN DUNN.
| 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.