MRS. ALICIA MAY MANCINI (NPI# 1356650006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356650006 |
| Entity Type | Individual |
| Full Name | MRS. ALICIA MAY MANCINI |
| Other Name | MISS ALICIA MAY WILLS |
| Credential | PA-C |
| Practice Address |
4100 Lake Dr Se Suite 205 Grand Rapids MI 49546-8292 |
| Mailing Address |
100 Michigan St Ne Mc-845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6162677100 |
| Practice Fax Number | 6162677102 |
| Mailing Telephone | 6162677100 |
| Mailing Fax Number | 6162677102 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2016-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601007930 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
002477 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548583735 | Alicia Camille Mancini | Pharmacist | 13723 N Litchfield Rd, Surprise, AZ 85379-4268 | 2010-03-02 |
| 1528131927 | Alicia Ann Mancini | Physical Therapist | 721 Reservoir Ave, Cranston, RI 02910-4430 | 2006-11-16 |
| Street Address |
4100 LAKE DR SE SUITE 205 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-8292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366438632 | Spectrum Health Hospitals | Clinic/Center | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2005-09-22 |
| 1073146411 | James Walejewski | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2020-02-13 |
| 1811458557 | Michelle Kuzma | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2019-03-26 |
| 1063943991 | Maggie Anstett | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2017-03-22 |
| 1851746671 | Luke Murray | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2016-04-29 |
| 1942665237 | Alyssa Susanne Baker | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-31 |
| 1619332806 | Elizabeth Albert | Specialist/Technologist | 4100 Lake Dr Se, Suite 300, Grand Rapids, MI 49546-8292 | 2015-12-15 |
| 1609247618 | Rebecca Preston | Psychologist | 4100 Lake Dr Se, Suite B01, Grand Rapids, MI 49546-8292 | 2015-10-16 |
| 1255708921 | Timothy Glerum | Nurse Practitioner | 4100 Lake Dr Se, Suite 205, Grand Rapids, MI 49546-8292 | 2015-08-28 |
| 1730556796 | Samantha Ford | Specialist/Technologist | 4100 Lake Dr Se, Grand Rapids, MI 49546-8292 | 2015-08-26 |
| Find all providers in the same location | ||||
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1285681536 | Susan G Laham | Physician Assistant | 1425 Michigan St Ne, Suite D, Grand Rapids, MI 49503-2027 | 2006-05-30 |
| 1891768065 | Paul Loh | Physician Assistant | 100 Michigan St Ne, Mc 103, Suite 8830, Grand Rapids, MI 49503-2560 | 2006-02-08 |
| 1366439432 | Michael Lee Bills | Physician Assistant | 4100 Lake Dr Se Ste 300, Grand Rapids, MI 49546-8292 | 2005-10-04 |
| 1285633172 | Adam J Geller | Physician Assistant | 1300 Michigan St Ne Ste 200, Grand Rapids, MI 49503-2029 | 2005-07-21 |
| 1649787128 | Corey John Koll | Physician Assistant | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-01-05 |
| 1811439763 | Danielle Susan Douglass | Physician Assistant | 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503-2515 | 2016-11-09 |
| 1982078515 | Laura E Stevenson | Physician Assistant | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2015-11-19 |
| 1932570975 | Neurosurgery Health Services Plc | Physician Assistant | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2015-10-16 |
| 1427437177 | Ian Gary Mcbain | Physician Assistant | 221 Michigan St Ne Ste 400, Grand Rapids, MI 49503-2543 | 2015-05-28 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on MRS. ALICIA MAY MANCINI.
| 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.