MAVJUDA SAYDAZAMOVA (NPI# 1538705660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538705660 |
| Entity Type | Individual |
| Full Name | MAVJUDA SAYDAZAMOVA |
| Credential | FNP |
| Practice Address |
80 68th St Se Grand Rapids MI 49548-6980 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6163918242 |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2020-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
4704324263 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
80 68TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49548-6980 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275529562 | Spectrum Health Hospitals | Clinic/Center | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2005-09-22 |
| 1033746565 | Samantha Nicole Lubbers | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2020-03-25 |
| 1912531054 | Christof Charles Muller | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2020-02-27 |
| 1477185718 | Austin James Redick | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2020-02-05 |
| 1770114266 | George Michael Mcconnell | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2020-02-03 |
| 1245861251 | Holly Elizabeth Mullen | Nurse Practitioner | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2020-01-29 |
| 1417596008 | Jennifer Nicole Lehman | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2019-12-30 |
| 1396398236 | Marlee Jayne Bogema | Nurse Practitioner | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2019-07-19 |
| 1013472695 | Micah Nahum Foster | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2019-02-07 |
| 1912470493 | Callie Marie Radford | Physician Assistant | 80 68th St Se, Grand Rapids, MI 49548-6980 | 2019-01-07 |
| Find all providers in the same location | ||||
| 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 | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306318498 | Ashley Marie Jacobson | Nurse Practitioner | 4100 Lake Dr Se Ste D, Grand Rapids, MI 49546-8292 | 2018-12-30 |
| 1568931673 | Jennifer Lavigne | Nurse Practitioner | 145 Michigan St Ne Ste 3300, Grand Rapids, MI 49503-2562 | 2018-11-19 |
| 1851886220 | Laura Maclam | Nurse Practitioner | 524 Marywood Dr Ne, Grand Rapids, MI 49505-4149 | 2018-06-27 |
| 1609482330 | Amy Manderscheid | Nurse Practitioner | 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 | 2020-09-18 |
| 1417563339 | Samantha Marie Utter | Nurse Practitioner | 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 | 2020-09-16 |
| 1295343986 | Elizabeth Ann Evans | Nurse Practitioner | 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 | 2020-07-19 |
| 1669098935 | Andrea Lynn Giffel | Nurse Practitioner | 145 Michigan St Ne Ste 3410, Grand Rapids, MI 49503-2563 | 2020-06-22 |
| 1326672767 | Andrea Patrice Sewell | Nurse Practitioner | 25 Michigan St Ne Ste 6100, Grand Rapids, MI 49503-2561 | 2020-02-25 |
| 1356971261 | Sarah Marie Nava | Nurse Practitioner | 100 Michigan St Ne # Mc019, Grand Rapids, MI 49503-2560 | 2020-01-20 |
| 1790323970 | Joshua Dennis Witherspoon | Nurse Practitioner | 7751 Byron Center Ave Sw, Suite C, Grand Rapids, MI 49351 | 2019-12-18 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49548 |
Please comment or provide details below to improve the information on MAVJUDA SAYDAZAMOVA.
| 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.