JILL SIDANGE (NPI# 1588060750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588060750 |
Entity Type | Individual |
Full Name | JILL SIDANGE |
Practice Address |
24424 W Mcnichols Rd Detroit MI 48219-3653 |
Practice Telephone | 3135312500 |
Enumeration Date | 2014-11-14 |
Last Update Date | 2015-10-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704265752 | MI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | N P SPECIALTY CERTIFICATE | 4704265752 | 01 |
Street Address |
24424 W MCNICHOLS RD |
City | DETROIT |
State | MI |
Zip Code | 48219-3653 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326135047 | Development Centers, Inc. | Social Worker | 24424 W Mcnichols Rd, Detroit, MI 48219 | 2006-10-06 |
1083229249 | Catrina Tookes | Social Worker | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2020-09-14 |
1770198970 | Wanda Mitchell | Voluntary or Charitable | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2020-09-14 |
1295351161 | Anna Marie Mier | Social Worker | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2020-06-17 |
1275165797 | Tenna Ramona Harris | Social Worker | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2020-02-12 |
1780232835 | Jamie Lee Ann Douglas | Psychologist | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2019-09-02 |
1306491824 | Stacy Lynette Saylor | Social Worker | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2019-08-02 |
1821561960 | Henry Lee Hampton | Peer Specialist | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2019-01-10 |
1982174710 | Claude Ray Winton II | Peer Specialist | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2018-12-05 |
1164904009 | Sarah Mcintire | Peer Specialist | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2018-09-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891396008 | Betty Jean Fairchild-el | Home Health Aide | 20018 Norhtrop, Detroit, MI 48219 | 2020-11-04 |
1134787633 | Behavioral Health Professionals, Inc | Family Medicine | 19750 Burt Road, Detroit, MI 48219 | 2019-05-31 |
1255997755 | Shvaughn Laniece Nunley | Social Worker | 18422 W Mcnichols Rd, Detroit, MI 48219 | 2019-05-10 |
1770081168 | D & D Enterprise Group LLC | Durable Medical Equipment & Medical Supplies | 17405 Lahser, 202, Detroit, MI 48219 | 2018-01-31 |
1972011369 | Fibers of The Family LLC | Home Health | 16800 Edinborough Rd, Detroit, MI 48219 | 2018-01-19 |
1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
1114379773 | Audrey Hopkins | Licensed Practical Nurse | 20277 Redfren, Detroit, MI 48219 | 2016-07-07 |
1649628785 | Erin Bianco | Social Worker | 17321 Telegraph Rd., Detroit, MI 48219 | 2016-05-31 |
1144674664 | Lucinda Galmon-wallace | Technician, Other | 24424 Telegraph Road, Detroit, MI 48219 | 2016-04-21 |
1598120925 | Faith's Place LLC | Psychiatric Residential Treatment Facility | 16725 Blackstone Street, Detroit, MI 48219 | 2015-12-30 |
Find all providers in zip 48219 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
1821180274 | Carla J Groh | Nurse Practitioner | 5555 Conner, Suite 2691, Detroit, MI 48213 | 2006-09-29 |
1124054408 | Patricia Frances Yourchock Orr | Nurse Practitioner | 4464 Burton St, Upper Unit, Detroit, MI 48210-2402 | 2006-06-25 |
1720619091 | Sunshine Mental Health Care | Nurse Practitioner | 12871 E Jefferson Ave, Detroit, MI 48215-2754 | 2020-01-27 |
1720621535 | Rebecca Anne Hibbs | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2019-10-24 |
1659895134 | Infinity Hope Center | Nurse Practitioner | 277 Gratiot Ave Ste 100a8919, Detroit, MI 48226-2239 | 2017-07-27 |
1942685607 | Eddia Marie Mcdade | Nurse Practitioner | 10 Peterboro St, Detroit, MI 48201-2722 | 2015-07-23 |
1043698475 | Karen Ann Wezner | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2015-05-18 |
1285023226 | Lauren Krist | Nurse Practitioner | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-01-14 |
Find all providers in DETROIT |
Please comment or provide details below to improve the information on JILL SIDANGE.
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.