MS. JUDITH MCKENNA (NPI# 1255322467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255322467 |
| Entity Type | Individual |
| Full Name | MS. JUDITH MCKENNA |
| Credential | RN, NP |
| Practice Address |
15855 19 Mile Rd Clinton Township MI 48038-3504 |
| Practice Telephone | 5862955387 |
| Practice Fax Number | 8107944124 |
| Mailing Telephone | 5862955387 |
| Mailing Fax Number | 8107944124 |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2009-05-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704145383 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4605447 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427533504 | Judith A Mckenna | Social Worker | 77 Sunset Rd, Arlington, MA 02474-2646 | 2018-09-25 |
| 1699765263 | Judith Arlene Mckenna | Social Worker | 105 Sullivan St, Apartment 3a, New York, NY 10012-3669 | 2005-10-25 |
| 1013114180 | Judith A Mckenna | Counselor | 941 El Dorado Ave, Santa Cruz, CA 95062-2863 | 2007-06-30 |
| 1982813978 | Judith Anne Mckenna | Optometrist | 102 Commonwealth Ct, Cary, NC 27511-4400 | 2007-05-22 |
| Street Address |
15855 19 MILE RD |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip Code | 48038-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497378301 | Steven Leonowicz II | Family Medicine | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-05-26 |
| 1033739735 | Seth Ramin Ashraf | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-04-22 |
| 1558990705 | Alan Rupp | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-04-08 |
| 1538798749 | Nadia Khan | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-04-08 |
| 1700415643 | Shyamal Pansuriya | Surgery | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-04-03 |
| 1598394306 | Archana Chandrashekar | Surgery | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-04-03 |
| 1326676503 | Ashish Sripathi Kalakuntla | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-04-01 |
| 1407484116 | Taylor M Timoteo | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-03-29 |
| 1639707458 | Philip Soni Chacko | Surgery | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-03-28 |
| 1952938938 | Jordynn Baldwin | Student in an Organized Health Care Education/Training Program | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447864129 | Raphael Antonio Tramble | Counselor | River Oaks Suites Plaza 42815 Garfield Road, Suite 201, Clinton Township, MI 48038 | 2020-09-01 |
| 1275160384 | Varun C Sankuratri | Obstetrics & Gynecology | 16515 Nineteen Mile Rd, Gme Office: Attention Obgyn PC Kelly Bennet, Clinton Township, MI 48038 | 2020-03-26 |
| 1114563178 | Hopeful Reflections Counseling Center, Pllc | Counselor | 44444 Hayes, Clinton Township, MI 48038 | 2019-11-25 |
| 1588224570 | Karrie Marie Armstrong | Social Worker | 42815 Garfield Rd Macomb Therapy Group, Suite 201, Clinton Twp, MI 48038 | 2019-06-20 |
| 1386201424 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr Ste #2, Clinton Twp, MI 48038 | 2019-05-23 |
| 1306314489 | Rx Mart Pharmacy LLC | Pharmacy | 43171 Dalcoma Dr., Suite 2, Clinton Twp, MI 48038 | 2018-11-07 |
| 1730677592 | Najoi Sleiman | Physical Medicine & Rehabilitation | 15855 19-mile Road, Rehab Services, 4th Floor, South Tower, Clinton Twp., MI 48038 | 2018-04-27 |
| 1295230365 | David Michael Ragbeer | Emergency Medicine | Henry Ford Macomb Hospitals, 15855 Nineteen Mile Road, Clinton Township, MI 48038 | 2018-03-29 |
| 1932601317 | Synergy Pharmacy LLC | Pharmacy | 42621 Garfield Rd Ste 101a, Clinton Township, MI 48038 | 2018-03-01 |
| 1689175002 | Melissa Velez Miracle | Speech-Language Pathologist | 38809 Windmill Pointe W, Clinton Twp, MI 48038 | 2018-02-21 |
| Find all providers in zip 48038 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912564899 | Jill Dolores Combs | Nurse Practitioner | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2019-05-25 |
| 1538638564 | Tina Crocenzi | Nurse Practitioner | 38770 Garfield Rd, Ste 102, Clinton Township, MI 48038-6631 | 2018-11-20 |
| 1154897809 | Ligia Martinescul | Nurse Practitioner | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2018-10-21 |
| 1538634126 | Cheron Bibbs | Nurse Practitioner | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2018-10-10 |
| 1770099079 | Kacie Stoll | Nurse Practitioner | 43900 Garfield Rd Ste 100, Clinton Township, MI 48038-1137 | 2017-12-21 |
| 1902346760 | Ryan Schmid | Nurse Practitioner | 15855 19 Mile Rd, Clinton Township, MI 48038-3504 | 2017-02-27 |
| 1295065951 | Christine Holly Shantry | Nurse Practitioner | 15855 19 Mile Rd, Emergency Dept, Clinton Township, MI 48038-3504 | 2009-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | CLINTON TOWNSHIP |
| Zip Code | 48038 |
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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.