MICHELLE R GUSTAFSON (NPI# 1497126874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497126874 |
| Entity Type | Individual |
| Full Name | MICHELLE R GUSTAFSON |
| Credential | FNP-C |
| Practice Address |
535 E Mckellips Rd Ste 111 Mesa AZ 85203-2525 |
| Mailing Address |
26500 Agoura Rd Ste 102-587 Calabasas CA 91302-1952 |
| Practice Telephone | 4802231333 |
| Practice Fax Number | 6023823036 |
| Mailing Telephone | 8188808605 |
| Mailing Fax Number | 8185797916 |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2020-07-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP8221 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3210 E Union Hills Dr, Phoenix, AZ 850503223 | 6027884793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700823952 | Michelle Lee Gustafson | Social Worker | Fairview University Hospital, 2450 Riverside Avenue South, Mpls, MN 55454 | 2006-05-31 |
| 1881873602 | Michelle A Gustafson | Social Worker | 3711 Long Beach Blvd, Suite 600, Long Beach, CA 90807-3315 | 2007-10-29 |
| Street Address |
535 E MCKELLIPS RD STE 111 |
| City | MESA |
| State | AZ |
| Zip Code | 85203-2525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295760916 | Pain Management & Rehabilitation Medicine Center PC | Radiology | 535 E Mckellips Rd Ste 111, Mesa, AZ 85203-2525 | 2006-07-11 |
| 1013439520 | First Nations Limb Preservation Foundation | Radiology | 535 E Mckellips Rd Ste 111, Mesa, AZ 85203-2525 | 2017-07-17 |
| 1427583087 | Modern Vascular of Mesa, LLC | Family Medicine | 535 E Mckellips Rd Ste 111, Mesa, AZ 85203 | 2017-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1598251142 | Jonathan Harris | Physician Assistant | 220 N Stapley Dr Ste B, Mesa, AZ 85203 | 2018-07-06 |
| 1316437502 | Arizona's Children Association | Clinic/Center | 1345 E Main St Ste 104, Mesa, AZ 85203 | 2018-05-14 |
| 1922506856 | Hernimarc Durable Medical Equipment | Durable Medical Equipment & Medical Supplies | 1350 E Mckellips Rd Ste 3, Mesa, AZ 85203 | 2018-01-25 |
| 1912411638 | Charles Rudy Wermuth | Surgery | Charles R. Mermuth M.d., 2615 N Barkley, Mesa, AZ 85203 | 2017-11-17 |
| 1841714631 | J. Susanne Davis | Chiropractor | 62 N. Stapley Drive, Mesa, AZ 85203 | 2017-08-02 |
| 1699295329 | Preferred Homecare Infusion LLC | Home Health | 1134 E University Dr Ste 110, Mesa, AZ 85203 | 2017-06-23 |
| 1619407442 | Modern Vascular Institute LLC | Internal Medicine | 535 E Mckellips Rd Ste 115, Mesa, AZ 85203 | 2017-06-14 |
| 1962951632 | Julia A. Gunthner | Counselor | 1528 E. Gary St., Mesa, AZ 85203 | 2016-09-23 |
| 1689121105 | Justine Muntz | Occupational Therapy Assistant | 1304 E. Harvest, Mesa, AZ 85203 | 2016-09-01 |
| Find all providers in zip 85203 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926410 | Matthew Derrick Miller | Nurse Practitioner | 9354 E Thatcher Cir, Mesa, AZ 85212-8539 | 2020-09-12 |
| 1750995858 | Hayley Madler | Nurse Practitioner | 1061 N Omaha Cir, Mesa, AZ 85205-5023 | 2020-09-04 |
| 1043823800 | Nancy Lynn Mitchell | Nurse Practitioner | 1535 N 26th St, Mesa, AZ 85213-4151 | 2020-08-30 |
| 1003429218 | Krista Ann Clevenger | Nurse Practitioner | 3155 E Southern Ave Ste 203, Mesa, AZ 85204-5521 | 2020-08-26 |
| 1093326290 | Joshua Jackson | Nurse Practitioner | 5432 E Southern Ave Ste 101b, Mesa, AZ 85206-2772 | 2020-08-11 |
| 1790395531 | Kelly C Banonis | Nurse Practitioner | 3322 N Brighton, Mesa, AZ 85207-0997 | 2020-08-06 |
| 1689284911 | Katie Keil | Nurse Practitioner | 1061 N Dobson Rd Ste 107, Mesa, AZ 85201-7576 | 2020-08-02 |
| 1831711670 | Saraswati Hamal | Nurse Practitioner | 4850 S Curie Way, Mesa, AZ 85212-9582 | 2020-05-14 |
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1659992436 | Elizabeth Erb | Nurse Practitioner | 1361 S Alma School Rd, Mesa, AZ 85210-2085 | 2020-05-02 |
| Find all providers in MESA | ||||
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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.