ALICIA PUEBLO (NPI# 1417507344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417507344 |
| Entity Type | Individual |
| Full Name | ALICIA PUEBLO |
| Practice Address |
524 W Centre Ave Portage MI 49024-5306 |
| Mailing Address |
2404 Hazel Ave Kalamazoo MI 49008-2714 |
| Practice Telephone | 2693241180 |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2019-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703114479 | MI | Nursing Service Providers |
| Street Address |
524 W CENTRE AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-5306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548304645 | Advantage Private Nursing Services, Inc | Nursing Care | 524 W Centre Ave, Portage, MI 49024-5306 | 2007-02-20 |
| 1316570203 | Lori Ellis | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2020-02-19 |
| 1952872665 | Janis Callahan | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-12-07 |
| 1992280465 | Lisa Chapman | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-10-01 |
| 1477031664 | Heather Bakken | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-07-31 |
| 1356828743 | Penny Devries | Licensed Practical Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-07-27 |
| 1134614829 | Todd Pushee | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-26 |
| 1154816965 | Vicki Lynn Gates | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-25 |
| 1689168783 | Gloria Bloom | Registered Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-21 |
| 1699269456 | Bernard Mun | Licensed Practical Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699263624 | Joelynn Bigheart | Licensed Practical Nurse | 2787 Emerson St, Portage, IN 46368-3305 | 2018-04-25 |
| 1114311164 | Michelle Meulman | Licensed Practical Nurse | 9439 S Westnedge Ave, Portage, MI 49002-6855 | 2015-03-26 |
| 1720343205 | Angela Vantreeck | Licensed Practical Nurse | W6610 Hwy 33, Portage, WI 53901-9114 | 2012-07-10 |
| 1659630127 | Eric Allen Eichline | Licensed Practical Nurse | N9402 County Road X, Portage, WI 53901-9462 | 2012-05-03 |
| 1700105012 | Eric Ochieng Okoth | Licensed Practical Nurse | 1916 Vickery Rd, Portage, MI 49002-7610 | 2010-05-26 |
| 1063686830 | Christine Linn Warner | Licensed Practical Nurse | 15590 Greensburg Pike, Portage, OH 43451-9764 | 2008-04-14 |
| 1356828743 | Penny Devries | Licensed Practical Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-07-27 |
| 1699269456 | Bernard Mun | Licensed Practical Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-15 |
| 1861986697 | Laurel Say | Licensed Practical Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-15 |
| 1285128009 | Lateka Wade | Licensed Practical Nurse | 524 W Centre Ave, Portage, MI 49024-5306 | 2018-06-15 |
| Find all providers in PORTAGE | ||||
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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.