JESSICA PRUSA (NPI# 1477944023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477944023 |
| Entity Type | Individual |
| Full Name | JESSICA PRUSA |
| Practice Address |
2829 Division Ave S Wyoming MI 49548-1152 |
| Practice Telephone | 6162489030 |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302039911 | MI | Pharmacy Service Providers |
| Street Address |
2829 DIVISION AVE S |
| City | WYOMING |
| State | MI |
| Zip Code | 49548-1152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770590754 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2829 Division Ave S, Wyoming, MI 49548-1152 | 2006-08-02 |
| 1750666749 | Beth Haverkamjp | Pharmacist | 2829 Division Ave S, Wyoming, MI 49548-1152 | 2011-10-21 |
| 1356622575 | Latricia Andersen | Pharmacist | 2829 Division Ave S, Wyoming, MI 49548-1152 | 2011-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319811 | Pooja Patel | Social Worker | Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2018-09-10 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1871099481 | Baymark of Michigan, Inc. | Clinic/Center | 5500 Division Avenue Se, Kentwood, MI 49548 | 2018-04-03 |
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1821548504 | Alison Anderson | Technician, Other | 103 Roth St Se, Grand Rapids, MI 49548 | 2016-10-06 |
| 1831540152 | Jesse Aubil | Counselor | 264 Montebello St. Se 49548, Grand Rapids, MI 49548 | 2016-06-28 |
| 1306237920 | Sarah Benton | Social Worker | 225 Colrain St Sw, 2, Grand Rapids, MI 49548 | 2015-02-18 |
| 1578996856 | Karen Marie Irving | Social Worker | 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2013-08-09 |
| 1740348044 | Robert Kenneth Richmond | Preventive Medicine | 551 36th Street. Se, Wyoming, MI 49548 | 2006-12-05 |
| 1386738953 | Sharita Montiez Hall | Social Worker | 300 68th Street Se, Grand Rapids, MI 49548 | 2006-10-03 |
| Find all providers in zip 49548 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720626526 | Dawn Ngoc Nguyen | Pharmacist | 2926 Florence Dr Sw, Wyoming, MI 49418-9736 | 2019-12-12 |
| 1518494954 | Nhi Uyen Tran | Pharmacist | 3010 Boone Ave Sw, Wyoming, MI 49519-7006 | 2017-05-16 |
| 1407305675 | Timothy Bos | Pharmacist | 2207 Porter St Sw # Condo108, Wyoming, MI 49519-2276 | 2016-09-28 |
| 1518374677 | Todd Anthony Penn | Pharmacist | 4330 Timber Ridge Trl Sw, Apt. 10, Wyoming, MI 49519-6426 | 2014-07-21 |
| 1679850077 | Theodore Wentworth | Pharmacist | 4457 Penny Lane Sw, Wyoming, MI 49418 | 2011-11-14 |
| 1558645127 | Pamela K Mitchell | Pharmacist | 4560 Penny Ln Sw, Wyoming, MI 49418-8324 | 2011-09-30 |
| 1144503723 | Robin A Curtis | Pharmacist | 1550 Gezon Pkwy Sw Ste E-100, Wyoming, MI 49509-9397 | 2011-09-21 |
| 1679854111 | Pam Lowing | Pharmacist | 1550 36th St Sw, Wyoming, MI 49509-3409 | 2011-08-29 |
| 1467627315 | Kassia O'brien | Pharmacist | 21 Kingstown Rd, Wyoming, RI 02898-1101 | 2008-04-22 |
| 1699810648 | Kevin Michael Smith | Pharmacist | 16 Chelsea Farm Dr, Wyoming, RI 02898-1221 | 2007-02-20 |
| Find all providers in WYOMING | ||||
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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.