MRS. CARRIE LYNN DEXTROM (NPI# 1437626256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437626256 |
Entity Type | Individual |
Full Name | MRS. CARRIE LYNN DEXTROM |
Practice Address |
9200 W Walker Rd Manton MI 49663-9315 |
Practice Telephone | 2318788352 |
Mailing Telephone | 2318783914 |
Enumeration Date | 2018-10-30 |
Last Update Date | 2018-10-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 372600000X | Adult Companion | Nursing Service Related Providers |
Street Address |
9200 W WALKER RD |
City | MANTON |
State | MI |
Zip Code | 49663-9315 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184191918 | Magnolia Care Afc Home LLC | Foster Care Agency | 9200 W Walker Rd, Manton, MI 49663-9315 | 2018-10-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639454986 | Manton Family Pharmacy Inc | Pharmacy | 117 W Main St, Manton, MI 49663 | 2011-10-19 |
1477641926 | Bostick Drug Store Inc | Pharmacy | 117 W Main St, Manton, MI 49663 | 2006-10-10 |
1669862546 | Hilda Schut | Massage Therapist | 7144 E 14 Rd, Manton, MI 49663-8600 | 2015-01-29 |
1821549858 | Katie Gardner | Specialist/Technologist | 5851 W Moorestown Rd, Manton, MI 49663-9012 | 2016-10-14 |
1558900720 | Manton Family Pharmacy Inc | Pharmacy | 117 W Main St, Manton, MI 49663-9026 | 2020-01-05 |
1578817854 | Bonnie Lou Perkins/crackel | Contractor | 116 Roberts St, Manton, MI 49663-9124 | 2012-11-07 |
1093287203 | Stephen Hooper | Transportation Broker | 212 Pine St, Manton, MI 49663-9128 | 2018-12-28 |
1922551852 | Manton Medical Equipment, LLC | Health Maintenance Organization | 113 E Main St, Manton, MI 49663-9152 | 2016-07-27 |
1578992459 | Karla Long | Physical Therapy Assistant | 413 W Main St, Manton, MI 49663-9156 | 2013-11-01 |
1518358779 | Mary Schmidt | Registered Nurse | 9091 W Walker Rd, Manton, MI 49663-9311 | 2015-02-10 |
Find all providers in zip 49663 |
Taxonomy Code | 372600000X |
Grouping | Nursing Service Related Providers |
Classification | Adult Companion |
An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275131112 | Kimberly Ann Walker | Adult Companion | 452 Bay St, Pontiac, MI 48342-1912 | 2020-10-13 |
1093346462 | Easy Living Assistance | Adult Companion | 41000 Woodward Ave Suite E 350, Bloomfield Twp, MI 48304 | 2020-02-04 |
1346883618 | Barbara Rodriguez | Adult Companion | 2295 N Winn Rd, Mount Pleasant, MI 48858-9736 | 2019-10-19 |
1407415730 | Monesha Maria Moore | Adult Companion | 29555 Laurel Woods Dr Apt 205, Southfield, MI 48034-4664 | 2019-06-11 |
1407412638 | Geisha Shanee Burton | Adult Companion | 8160 E Lantz St, Detroit, MI 48234-3303 | 2019-05-13 |
1639636855 | Latesa Renae Thomas | Adult Companion | 11611 Grayton St, Detroit, MI 48224-1643 | 2019-02-24 |
1912470907 | Austyn Desean Hollingshed | Adult Companion | 485 Hustler St, Gwinn, MI 49841-2902 | 2019-01-02 |
1205323086 | Theresa A Akin | Adult Companion | 20485 Goddard St Apt 102, Detroit, MI 48234-1354 | 2018-04-17 |
1114442084 | Rhonda Lewis | Adult Companion | 18603 Mendota St, Detroit, MI 48221-1911 | 2017-08-11 |
1275062002 | Iyeshia Galloway | Adult Companion | 5075 Farmbrook St, Detroit, MI 48224-1377 | 2017-06-06 |
Find all providers with the same taxonomy |
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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.