MISS CHRISTINE RENEE CONNER-BONGO (NPI# 1174663074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174663074 |
| Entity Type | Individual |
| Full Name | MISS CHRISTINE RENEE CONNER-BONGO |
| Credential | NP-C |
| Practice Address |
4700 Schaefer Rd Dearborn MI 48126-3698 |
| Mailing Address |
200 Oceangate #100 Long Beach CA 90802-4317 |
| Practice Telephone | 8885625442 |
| Practice Fax Number | 5624996171 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 5624996171 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2017-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704181197 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4700 SCHAEFER RD |
| City | DEARBORN |
| State | MI |
| Zip Code | 48126-3698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831169911 | Suhail M Banister | Pediatrics | 4700 Schaefer Rd, Dearborn, MI 48126-3698 | 2006-01-23 |
| 1649820986 | Western Wayne Family Health Centers | Clinic/Center | 4700 Schaefer Rd, Dearborn, MI 48126-3655 | 2019-09-18 |
| 1497279020 | Molina Medical Group of Michigan, PC | Family Medicine | 4700 Schaefer Rd, Dearborn, MI 48126-3655 | 2017-07-26 |
| 1861931941 | Wassim Abouarabi | Nurse Practitioner | 4700 Schaefer Rd, Dearborn, MI 48126-3655 | 2017-02-22 |
| 1316497761 | Molina Medical Group of Michigan, PC | Clinical Medical Laboratory | 4700 Schaefer Rd, Dearborn, MI 48126-3655 | 2016-10-10 |
| 1407204134 | Molina Medical Group of Michigan, PC | Obstetrics & Gynecology | 4700 Schaefer Rd, Dearborn, MI 48126-3698 | 2016-06-03 |
| 1831595040 | Angela Elaine Eburuche | Nurse Practitioner | 4700 Schaefer Rd, Dearborn, MI 48126-3698 | 2014-11-16 |
| 1316368582 | Haya Altown | Physician Assistant | 4700 Schaefer Rd, Dearborn, MI 48126 | 2013-12-13 |
| 1174880736 | Oakwood Dentists P.l.l.c. | Dentist | 4700 Schaefer Rd, #109, Dearborn, MI 48126-3698 | 2012-04-19 |
| 1134492465 | University Physician Group | Eyewear Supplier (Equipment, not the service) | 4700 Schaefer Rd, Suite 260, Dearborn, MI 48126-3698 | 2012-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1275148165 | Anasthesia Pain Service PC | Clinic/Center | 15350 Michigan Ave, Dearborn, MI 48126 | 2020-09-09 |
| 1417501958 | Ximena Noemi Ortega | Behavior Technician | 6241 Miller Rd, Dearborn, MI 48126 | 2019-08-01 |
| 1912478827 | Abar Alghazali | Behavior Technician | 4641 Lois, Dearborn, MI 48126 | 2018-12-17 |
| 1861972457 | Laboratory Specialists of Michigan, LLC | Clinical Medical Laboratory | 13530 Michigan Ave Ste 240, Dearborn, MI 48126 | 2018-08-14 |
| 1528544806 | Farah Osman | Pharmacist | 14715 Ford Rd, Dearborn, MI 48126 | 2018-07-19 |
| 1255821328 | Loyal Pharmacy LLC | Pharmacy | 7118 Greenfield Rd St(b), Dearborn, MI 48126 | 2018-05-15 |
| 1952803900 | Neetika Kesar | Physical Therapist | 15051, Ford Road, Dearborn, MI 48126 | 2018-03-06 |
| 1396247607 | David Jerome Kurcz | Physical Therapy Assistant | 15051 Ford Road, Henry Ford Village, Dearborn, MI 48126 | 2018-03-02 |
| 1043732506 | Shadiya Ahmed | Dentist | 4700 Schaefer Rd Ste 190, Dearborn, MI 48126 | 2017-07-16 |
| Find all providers in zip 48126 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699016030 | Aminah Al-saeedi | Nurse Practitioner | 10306 Dix, Dearborn, MI 48120-1561 | 2013-03-11 |
| 1740889328 | Samantha Kathleen Estelle Will | Nurse Practitioner | 1537 Monroe St, Dearborn, MI 48124-2842 | 2020-10-23 |
| 1316562432 | Laya Nasrallah | Nurse Practitioner | 5728 Schaefer Rd Ste 103, Dearborn, MI 48126-2287 | 2020-06-15 |
| 1568946325 | Mariann A Habhab | Nurse Practitioner | 1637 Monroe St, Dearborn, MI 48124-2912 | 2018-09-18 |
| 1689051088 | Kati Jo Shearer | Nurse Practitioner | 19401 Hubbard Dr, Dearborn, MI 48126-2641 | 2015-05-05 |
| 1649678285 | Joanne Abbas | Nurse Practitioner | 15400 Michigan Ave, Dearborn, MI 48126-3491 | 2014-12-14 |
| 1336570126 | Sheila Whelan | Nurse Practitioner | 1331 Monroe St, Suite 100, Dearborn, MI 48124-2888 | 2013-12-05 |
| 1396176327 | Noor S Kahook | Nurse Practitioner | 13244 W Warren Ave, Dearborn, MI 48126-1415 | 2013-12-02 |
| 1407138209 | Kimberli Monique Rhoiney | Nurse Practitioner | 6050 Greenfield Rd, Suite 101, Dearborn, MI 48126-6004 | 2011-09-16 |
| 1609169259 | Matrix Medical Network of Michigan, P.C. | Nurse Practitioner | 3200 Greenfield Rd Ste 300, Dearborn, MI 48120-1800 | 2011-05-16 |
| Find all providers in DEARBORN | ||||
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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.