MR. MICHAEL POULSEN (NPI# 1477094332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477094332 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL POULSEN |
| Credential | R.N. |
| Practice Address |
4455 Edison Lakes Pkwy Mishawaka IN 46545-1442 |
| Mailing Address |
1105 Mossy Ln Mishawaka IN 46544-9055 |
| Practice Telephone | 5742316894 |
| Mailing Telephone | 3174509807 |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
28219127A | IN | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770863243 | Michael Poulsen | Pharmacist | 1201 E State St, Rockford, IL 61104-2212 | 2011-08-27 |
| Street Address |
4455 EDISON LAKES PKWY |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46545-1442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891787321 | United Surgeons LLC | Clinic/Center | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2005-08-19 |
| 1023668423 | Labcorp Indiana Inc | Clinical Medical Laboratory | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1414 | 2019-09-17 |
| 1437600541 | Unity Hospitalist LLC | Hospitalist | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2016-10-24 |
| 1932650181 | Daniel Aizigov | Registered Nurse | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2016-10-21 |
| 1164896130 | Somnium Dme LLC | Durable Medical Equipment & Medical Supplies | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2015-11-13 |
| 1689063497 | Cheryl Yancey | Registered Nurse | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2015-01-16 |
| 1255732020 | Michael Myers | Pharmacist | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2014-09-11 |
| 1225441975 | United Surgeons, LLC | Pharmacy | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2014-06-10 |
| 1306194667 | Furhan Rashid Qureshi | Emergency Medicine | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 2012-08-16 |
| 1316294200 | Andre Levester Mccollough | Internal Medicine | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1414 | 2012-08-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
| 1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
| 1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
| Find all providers in zip 46545 | ||||
| Taxonomy Code | 163WM0705X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306294 | Angela Mamat | Registered Nurse | 2830 Woodside Ct, Evansville, IN 47711-6731 | 2020-11-03 |
| 1689271751 | Lorpu Gborkorquellie Benjamin | Registered Nurse | 3426 Aylesford Ln, Indianapolis, IN 46228-2880 | 2020-10-02 |
| 1447865498 | Erin Lynn Rammel | Registered Nurse | 411 W Tipton St., Schneck Professional Building, 4th Floor, Seymour, IN 47274-4727 | 2020-09-15 |
| 1568076628 | Haileigh Krotz | Registered Nurse | 3704 Tesla Dr, West Lafayette, IN 47906-0812 | 2020-09-04 |
| 1841803046 | Mariah Brooke Scheker | Registered Nurse | 14257 Chariots Whisper Dr, Carmel, IN 46074-8198 | 2020-08-26 |
| 1235754847 | Danielle Rodriguez | Registered Nurse | 12419 Washington St, Crown Point, IN 46307-5189 | 2020-06-09 |
| 1982225298 | Jana Reese | Registered Nurse | 2827 Millbrook Dr, Fort Wayne, IN 46802-3847 | 2020-04-28 |
| 1093204802 | Lisa Dunham | Registered Nurse | 105 N F St, Marion, IN 46952-3632 | 2018-05-07 |
| 1801306410 | Deandra Flowers | Registered Nurse | 6901 E 10th St Ste D, Indianapolis, IN 46219-4821 | 2017-10-10 |
| 1114399177 | Heather Marie Catlett | Registered Nurse | 101 Hoss Rd, Indianapolis, IN 46217-3423 | 2015-10-29 |
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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.