SUE ELLEN DUNHAM


Address: 4020 Copper Vw Ste 104, Traverse City, MI 49684
Phone: 2314216921

SUE ELLEN DUNHAM (NPI# 1427068790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427068790
Entity Type Individual
Full Name SUE ELLEN DUNHAM
Credential FNP
Practice Address 4020 Copper Vw Ste 104
Traverse City
MI 49684
Mailing Address 3785 Bay Rd
Saginaw
MI 48603-2433
Practice Telephone 2314216921
Practice Fax Number 2314217852
Mailing Telephone 9897912455
Mailing Fax Number 9897911392
Enumeration Date 2006-08-09
Last Update Date 2019-04-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 4704082241 MI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI BLUE CROSS BLUE SHIELD 5008770670 01
MI 4945609-10 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
115 E 7th St, Manton, MI 496639429 2318244100 2318244108

Office Location

Street Address 4020 COPPER VW STE 104
City TRAVERSE CITY
State MI
Zip Code 49684

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821604604 Kyrstin Rachael Sedlacek Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2020-09-17
1447868153 Deanna Humphrey Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2020-07-20
1841819521 Sarah Crowley Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2020-04-13
1023669918 Melanie Sue Lutz Social Worker 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2019-09-23
1508419177 Kari Ann Mark Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2019-07-22
1164085007 Julie Krauth Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2019-04-16
1558839696 Laura Ann Christopher Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2018-11-07
1407324601 Amy Rasmussen Dietitian, Registered 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2018-11-06
1013490663 Karri G Hagan Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684 2018-09-10
1033690326 Rebecca Louise Wiggins Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2018-08-24
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124641758 Karen Anne Paulosky Registered Nurse 226 S Madison St, Traverse City, MI 49684 2020-05-18
1891314795 Jaclyn Elizabeth Sylvain Student in an Organized Health Care Education/Training Program Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 2020-04-10
1285282988 Madelyn Drumm Dietitian, Registered 217 S. Madison St., Suite 3022, Traverse City, MI 49684 2019-08-27
1265917686 Kacie Danielle Heading Social Worker 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 2018-10-02
1881178325 Jacob White Ph.d., Pllc Psychologist 3537 W. Front Street, Suite F, Traverse City, MI 49684 2018-09-20
1144702572 Constance Baab, Phd, Lmsw, Pllc Social Worker 3301 Veterans Drive Suite 127, Traverse City, MI 49684 2018-09-01
1346732880 The Skin Cancer and Dermatology Center Plc Dermatology 1225 W Front St Ste 2, Traverse City, MI 49684 2018-05-31
1790283851 Lisa Louise Kleyps Massage Therapist 3337 W. South Airport Road #2, Traverse City, MI 49684 2018-01-24
1114447646 Brittany Alexandra Prior Physical Therapist 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 2017-06-26
1568902963 Jennifer Scott Behavior Technician 515 W 14th St Unit D, Traverse City, MI 49684 2017-03-03
Find all providers in zip 49684

Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871143685 Shannon Marie Hicks Nurse Practitioner 1109 Randolph St, Traverse City, MI 49684-2122 2019-09-13
1780026849 Jennifer Ann Marsh Nurse Practitioner 1221 Sixth St. Suite 300, Traverse City, MI 49684-2287 2013-07-17
1962597765 Karen M Wagner Nurse Practitioner 5024 N Royal Drive, Traverse City, MI 49684 2006-10-04
1336258953 Catherine Dilts Carter Nurse Practitioner 5024 N Royal Dr., Traverse City, MI 49684-9230 2006-08-29
1366461121 Mary Kay Williams Nurse Practitioner 1221 Sixth St Ste 306, Traverse City, MI 49684-2361 2006-07-19
1285690198 Jeanette A Kalupa Nurse Practitioner 1014 Sixth St, Suite 103, Traverse City, MI 49684-2381 2006-04-21
1821604604 Kyrstin Rachael Sedlacek Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2020-09-17
1457913337 Hannah M Popa Nurse Practitioner 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 2019-07-01
1669935003 Lavinia Sinziana Streza Nurse Practitioner 1105 6th St, Traverse City, MI 49684-2345 2019-04-11
1861957037 Michael Adam Gold Nurse Practitioner 2950 Lafranier Rd, Traverse City, MI 49686-4918 2019-02-01
Find all providers in TRAVERSE CITY

Competitor

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City TRAVERSE CITY
Zip Code 49684

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Dataset Information

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.

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