ELISE WIERSMA PAULK (NPI# 1407237548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407237548 |
| Entity Type | Individual |
| Full Name | ELISE WIERSMA PAULK |
| Credential | AGACNP-BC |
| Practice Address |
6001 W Outer Dr Suite 445 Detroit MI 48235-2614 |
| Mailing Address |
1560 E Maple Rd Suite 400 Troy MI 48083-1138 |
| Practice Telephone | 3139669777 |
| Practice Fax Number | 3139669767 |
| Mailing Telephone | 3139669777 |
| Mailing Fax Number | 3139669767 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
4704295406 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704295406 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704295406 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6001 W OUTER DR SUITE 445 |
| City | DETROIT |
| State | MI |
| Zip Code | 48235-2614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093780611 | Susan Elaine Harold | Internal Medicine | 6001 W Outer Dr, Suite 429, Detroit, MI 48235-2614 | 2006-02-17 |
| 1891396800 | Ashley Sentell | Nurse Practitioner | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2020-11-05 |
| 1841815974 | Heba Ahmed Elmadhoun | Pharmacist | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2020-06-15 |
| 1710495346 | Katherine Memisevic | Nurse Anesthetist, Certified Registered | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2018-01-17 |
| 1467985911 | Omar Elmadhoun | Student in an Organized Health Care Education/Training Program | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2017-04-11 |
| 1083161905 | Julia Marie Burkhardt | Physician Assistant | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2016-09-08 |
| 1902251879 | Mi Midwife | Advanced Practice Midwife | 6001 W Outer Dr, Suite #320, Detroit, MI 48235-2614 | 2016-04-28 |
| 1255708343 | Emily Bigas | Dietitian, Registered | 6001 W Outer Dr, Detroit, MI 48235-2614 | 2015-08-25 |
| 1457754533 | Reina Brojan Pearson | Nurse Practitioner | 6001 W Outer Dr, Suite 114, Detroit, MI 48235-2614 | 2014-10-02 |
| 1609286384 | Spectrum Surgical Specialist PC | Surgery | 6001 W Outer Dr, Suite 320, Detroit, MI 48235-2614 | 2014-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1629690565 | Faseeha Arshad Gondal | Student in an Organized Health Care Education/Training Program | Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 | 2020-05-14 |
| 1902428832 | Muhanad Abou Touk | Student in an Organized Health Care Education/Training Program | Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 | 2020-05-14 |
| 1780206730 | Ahmad Mismar | Student in an Organized Health Care Education/Training Program | Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 | 2020-05-13 |
| 1023630589 | Joao Paulo Fontana Bragagnollo | Student in an Organized Health Care Education/Training Program | 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 | 2020-05-07 |
| 1881216216 | Mohammad Awad Jaber | Student in an Organized Health Care Education/Training Program | 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 | 2020-05-07 |
| 1366064818 | Syeda Busmah Owais | Student in an Organized Health Care Education/Training Program | 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 | 2020-05-07 |
| 1184245680 | Sushmitha Nanja Reddy | Student in an Organized Health Care Education/Training Program | Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 | 2020-05-06 |
| 1972164796 | Jack Phillip Tomen | Student in an Organized Health Care Education/Training Program | Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 | 2019-06-24 |
| 1346809464 | Anusha Bapatla | Student in an Organized Health Care Education/Training Program | 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 | 2019-06-12 |
| Find all providers in zip 48235 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1811202310 | Ronda Lyn Bryant | Nurse Practitioner | 17600 Ryan Rd, Detroit, MI 48212-1155 | 2010-08-10 |
| 1104902915 | Kathleen Ann Brady | Nurse Practitioner | Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 | 2006-10-27 |
| 1619914199 | Sheryl Jean Marentette | Nurse Practitioner | 4646 John R St Ste A3118, Detroit, MI 48201-1916 | 2006-06-01 |
| 1952918740 | Lisa Colombo | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1558976928 | Ashley Mary Asmar | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2020-09-12 |
| 1881218790 | Erin Marie Dinnell | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-05 |
| 1780205179 | Sabastan Patrick Knight | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2020-04-27 |
| 1225673114 | Marlon Nicdao | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2019-11-14 |
| 1265077408 | Megan Nicole Hodson | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2689 | 2019-11-12 |
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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.