LAURA PUCKETT (NPI# 1558894683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558894683 |
| Entity Type | Individual |
| Full Name | LAURA PUCKETT |
| Practice Address |
3990 John R St 7 Brush N Mailbox 165 Detroit MI 48201-2018 |
| Mailing Address |
5525 N Stanton St Apt 29g El Paso TX 79912-6408 |
| Practice Telephone | 2826821363 |
| Mailing Telephone | 2816821363 |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588973580 | Laura Puckett | Pharmacist | 2994 Kildaire Farm Rd, Cary, NC 27518-9614 | 2010-09-25 |
| Street Address |
3990 JOHN R ST 7 BRUSH N MAILBOX 165 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619959707 | Candice Garwood | Pharmacist | 3990 John R St, Department of Pharmacy, Detroit, MI 48201-2018 | 2005-11-15 |
| 1396342085 | Tzu-bou Hsieh | Obstetrics & Gynecology | 3990 John R St, Detroit, MI 48201-2018 | 2020-10-06 |
| 1558976928 | Ashley Mary Asmar | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2020-09-12 |
| 1871102574 | Adam Ryan Mills | Registered Nurse | 3990 John R St, Detroit, MI 48201-2018 | 2020-07-28 |
| 1033734082 | Sean Lang | Pharmacist | 3990 John R St, Detroit, MI 48201-2018 | 2020-06-15 |
| 1568084259 | Carly Victoria Burns | Pharmacist | 3990 John R St, Detroit, MI 48201-2018 | 2020-05-15 |
| 1154941805 | Dustin David Reykdal | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1902426513 | Merva N. Gilani | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1659991271 | Elisabeth Lederman Wong | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1366080640 | Joel David Ziettlow | Nurse Anesthetist, Certified Registered | 3990 John R St, Detroit, MI 48201-2018 | 2019-12-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
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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.