DR. JENNIFER MICHELLE WOLLACK (NPI# 1265880140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265880140 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER MICHELLE WOLLACK |
| Other Name | JENNIFER MICHELLE KREZA |
| Credential | D.O. |
| Practice Address |
3955 Patient Care Dr Lansing MI 48911-4299 |
| Practice Telephone | 5173747600 |
| Practice Fax Number | 5179994018 |
| Mailing Telephone | 5173747600 |
| Mailing Fax Number | 8554955457 |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2020-02-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 5101022728 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3031 W Grand Blvd Ste 450, Detroit, MI 482023026 | 2482250423 |
| Street Address |
3955 PATIENT CARE DR |
| City | LANSING |
| State | MI |
| Zip Code | 48911-4299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033148804 | Sherman Gorbis | Neuromusculoskeletal Medicine & OMM | 3955 Patient Care Dr, Lansing, MI 48911 | 2006-07-02 |
| 1730686916 | Felix Alberto Chalu | Nurse Practitioner | 3955 Patient Care Dr, Lansing, MI 48911-4299 | 2018-04-12 |
| 1952820235 | Melinda S Vandyke | Nurse Practitioner | 3955 Patient Care Dr, Lansing, MI 48911-4299 | 2017-09-18 |
| 1649625708 | Richard Sharon | Internal Medicine | 3955 Patient Care Dr, Lansing, MI 48911 | 2016-04-26 |
| 1922410513 | Basil Dahbur | Internal Medicine | 3955 Patient Care Dr, Lansing, MI 48911-4299 | 2014-05-30 |
| 1033530894 | Katie Ann Sikes | Nurse Practitioner | 3955 Patient Care Dr, Suite B, Lansing, MI 48911-4299 | 2013-12-21 |
| 1821319443 | Joanne Castillo Rivera | Family Medicine | 3955 Patient Care Dr, Lansing, MI 48911-4299 | 2010-06-17 |
| 1972830636 | Jennifer Lynne Caswell | Physician Assistant | 3955 Patient Care Dr, Lansing, MI 48911 | 2009-11-17 |
| 1235323999 | Washtenaw Medical Pharmacy LLC | Pharmacy | 3955 Patient Care Dr, Lansing, MI 48911-4299 | 2007-09-05 |
| 1366648842 | Whitney Allison Hounshell | Internal Medicine | 3955 Patient Care Dr, Lansing, MI 48911 | 2007-06-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154943603 | Promissa Personalized Care Services LLC | Assisted Living Facility | 200 E Edgewood Blvd, Lansing, MI 48911 | 2020-05-07 |
| 1457911877 | Zachary Todd Goldstein | Pediatrics | Cedar Pediatrics 5303 S. Cedar St, Suite 205, Lansing, MI 48911 | 2019-06-18 |
| 1447713946 | Fadi Nuseibeh | Pharmacist | 3955 Patient Care Drive, Pharmacy, Lansing, MI 48911 | 2019-04-11 |
| 1740704543 | Kyle Lardie | Dental Hygienist | Care Free Medical and Dental 5135 S Pennsylvania Ave, Lansing, MI 48911 | 2017-08-02 |
| 1124549845 | Joash Michael Charles | Behavior Technician | 3720 Richmond Street, Lansing, MI 48911 | 2017-07-03 |
| 1205212164 | Benjamin Curtis Neal | Dentist | 5601 S Cedar St., Lansing, MI 48911 | 2015-08-03 |
| 1376927608 | Heather Lamb | Home Health | 2919 Risdale St, Lansing, MI 48911 | 2015-07-16 |
| 1669861712 | Lucas James Evan Joseph Bila | Licensed Practical Nurse | 2204 S. Wadsworth Dr, Lansing, MI 48911 | 2015-01-13 |
| 1649695271 | Aaron James Hart | Occupational Therapist | 3960 Patient Care Dr Ste 117, Lansing, MI 48911 | 2014-02-18 |
| 1831465871 | Los Equipment Corporation | Dentist | 6810 S. Cedar St, Suite 5, Lansing, MI 48911 | 2012-03-23 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1982235768 | Pine Point Medical, Pllc | Internal Medicine | 3105 N. Triphammer Road, Suite 7, Lansing, NY 14882-8906 | 2020-01-30 |
| 1487154290 | Edward W Sparrow Hospital Association | Internal Medicine | 1200 E Michigan Ave Ste 510, Lansing, MI 48912-1899 | 2018-02-19 |
| 1770094153 | Thomas M Bergren | Internal Medicine | 110 E Allegan St Apt 1, Lansing, MI 48933-1852 | 2017-10-12 |
| 1740543180 | Sundeev Singh Gill | Internal Medicine | 3955 Patient Care Dr Ste B, Lansing, MI 48911-4271 | 2012-06-20 |
| 1578837332 | Robert Russell Hillman | Internal Medicine | 1215 E Michigan Ave # 7, Lansing, MI 48912-1811 | 2012-02-26 |
| 1205147873 | Joshua P June | Internal Medicine | 3394 E Jolly Rd Ste C, Lansing, MI 48910-8595 | 2010-06-28 |
| 1790001816 | Fatima Sultan | Internal Medicine | 1200 E. Michigan Ave Ste 500, Lansing, MI 48912 | 2010-04-14 |
| 1790007359 | Thomas Louis Schneider | Internal Medicine | 920 Townsend St, Mc 489-066-046, Lansing, MI 48921-0001 | 2010-02-24 |
| 1376873760 | Soumya Madala Md Pllc | Internal Medicine | 3937 Patient Care Way Ste 102, Lansing, MI 48911-4287 | 2010-01-06 |
| Find all providers in LANSING | ||||
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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.