MRS. GWEN LEE (NPI# 1588905830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588905830 |
Entity Type | Individual |
Full Name | MRS. GWEN LEE |
Credential | RN |
Practice Address |
611 Martin Luther King Jr Blvd Detroit MI 48201-2273 |
Practice Telephone | 3138326300 |
Practice Fax Number | 3138322075 |
Mailing Telephone | 3138326300 |
Mailing Fax Number | 3138322075 |
Enumeration Date | 2013-03-12 |
Last Update Date | 2013-03-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
4704196136 | MI | Nursing Service Providers |
Street Address |
611 MARTIN LUTHER KING JR BLVD |
City | DETROIT |
State | MI |
Zip Code | 48201-2273 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275576886 | Ronaldo B Supena | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2006-06-13 |
1750732830 | Detroit Community Health Connection | Community/Behavioral Health | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2016-06-29 |
1295073773 | Lavetta Annette Pickens | Nurse Practitioner | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2013-01-18 |
1215200399 | Detroit Community Health Connection, Inc. | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2012-02-20 |
1841445640 | Norris Carnell Polk | Pediatrics | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-11-20 |
1851547038 | Marie Shoulders-williams | Nurse Practitioner | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-08-07 |
1790948982 | Detroit Community Health Connection, Inc | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-07-08 |
1427084128 | Mayra Troya-nutt | Obstetrics & Gynecology | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2006-06-24 |
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 |
Find all providers in zip 48201 |
Taxonomy Code | 163WG0000X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265033831 | Shelly Cromerkennedy | Registered Nurse | 14583 Archdale St, Detroit, MI 48227-1441 | 2020-11-02 |
1235674870 | Debora Ruckes Curtis | Registered Nurse | 18932 Pennington Dr, Detroit, MI 48221-2168 | 2017-01-05 |
1689725020 | Parthenia Henry | Registered Nurse | 3681 Preston St, Detroit, MI 48207-2447 | 2007-01-14 |
1730296070 | Donna Nealous Brown | Registered Nurse | 603 E Philadelphia St, Detroit, MI 48202-2224 | 2006-08-24 |
1588285084 | Jerome E Colon | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-05-06 |
1760011472 | Audrey Elizabeth Hua | Registered Nurse | 5557 Cass Ave, Detroit, MI 48202-3615 | 2020-04-04 |
1184265639 | Andrea Michelle Marshall-diver | Registered Nurse | 2925 Russell St, Detroit, MI 48207 | 2019-10-07 |
1104486877 | Lauren Alexis Kalliantasis | Registered Nurse | 22101 Moross Rd, Detroit, MI 48236-2148 | 2019-06-16 |
1336640903 | Tanika Arnold | Registered Nurse | 19940 Conant St, Detroit, MI 48234-1494 | 2018-02-28 |
1659665370 | Elizabeth Abraham Koyithot | Registered Nurse | 1 Ford Pl, Henry Ford Hospital, Detroit, MI 48202-3450 | 2011-05-31 |
Find all providers in DETROIT |
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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.