MS. MARILYN CARMELA KETCHUM (NPI# 1629390810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629390810 |
| Entity Type | Individual |
| Full Name | MS. MARILYN CARMELA KETCHUM |
| Credential | RN, CANP |
| Practice Address |
2310 E Michigan Ave Lansing MI 48912-4018 |
| Practice Telephone | 5173467628 |
| Practice Fax Number | 5173467629 |
| Mailing Telephone | 5173467628 |
| Mailing Fax Number | 5173467629 |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WG0000X |
Registered Nurse Specialization: General Practice |
4704149979 | MI | Nursing Service Providers |
| Street Address |
2310 E MICHIGAN AVE |
| City | LANSING |
| State | MI |
| Zip Code | 48912-4018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215939723 | Suzanne Rose Martini | Nurse Practitioner | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2005-08-15 |
| 1508285339 | Physician Coverage Services | Clinic/Center | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2014-04-09 |
| 1225354954 | George Howard Johnson | Physician Assistant | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2010-04-20 |
| 1841455284 | Ziena Saeed | Dietitian, Registered | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2008-07-24 |
| 1750446944 | Billie Sue Berman | Nurse Practitioner | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2006-12-27 |
| 1508875840 | East Michigan Family Care | Family Medicine | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2006-08-05 |
| 1295744530 | Shannon Georgeann Wiggins | Family Medicine | 2310 E Michigan Ave, Lansing, MI 48912-4018 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563646 | Shelley Gabel | Surgery | 1200 E Michigan Ave., Sparrow Professional Building Suite 655, Lansing, MI 48912 | 2020-06-23 |
| 1568087237 | Ahmed Mohamed Haggag | Student in an Organized Health Care Education/Training Program | 1215 East Michigan Avenue 3rd Floor, Lansing, MI 48912 | 2020-06-09 |
| 1467074773 | Craig Hargurkirat Malli | Family Medicine | 1215 E Michigan Avenue Suite 245, Lansing, MI 48912 | 2020-05-08 |
| 1215558945 | Temmy J. Brotherson | Family Medicine | Sparrow Health Systems, 1200 E Michigan Avenues, Suite 245, Lansing, MI 48912 | 2020-05-05 |
| 1386265452 | Kyle Patrick Doran | Emergency Medicine | Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI 48912 | 2020-04-30 |
| 1316418841 | Andrea Mcswain Do PC | Obstetrics & Gynecology | 1909 E. Michigan Ave, Lansing, MI 48912 | 2018-12-10 |
| 1215386115 | Michael Vernon Hollis | Student in an Organized Health Care Education/Training Program | 1500 E Michigan Ave, Suite 655, Lansing, MI 48912 | 2016-06-10 |
| 1518333970 | Eastside Community Action Center | Social Worker | 1001 Dakin Street, Suite B, Lansing, MI 48912 | 2015-08-19 |
| 1649667403 | Cheryl Ann Wade | Counselor | 1712 E Michigan Ave., Lansing, MI 48912 | 2015-04-20 |
| 1083006134 | Carol Pratt | Occupational Therapist | 1200 E. Michigan Ave, Outpatient Rehab - Lower Level, Lansing, MI 48912 | 2015-02-26 |
| Find all providers in zip 48912 | ||||
| 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 |
| 1487265559 | Rita N Shah | Registered Nurse | 30957 Franklin Woods Ct, Franklin, MI 48025-1512 | 2020-08-12 |
| 1558972737 | Tia Seale | Registered Nurse | 19001 E 8 Mile Rd Ste 102, Eastpointe, MI 48021-3247 | 2020-08-12 |
| 1568080869 | Aubrey Michelle Dewey | Registered Nurse | 49394 Nicholette, Utica, MI 48317-2282 | 2020-07-13 |
| 1659992311 | Michelle Anne Orrell | Registered Nurse | 8431 Winona Dr, Jenison, MI 49428-9540 | 2020-05-04 |
| 1871146084 | Amber Lee Smith | Registered Nurse | 441 County Road Ml, Negaunee, MI 49866-9084 | 2019-07-17 |
| 1275193450 | Tricia Kay Rosa | Registered Nurse | 6767 Knollview Dr, Hudsonville, MI 49426-9388 | 2019-06-19 |
| 1679047278 | Margiejo D Packham | Registered Nurse | 109 W Memorial Dr, Hancock, MI 49931 | 2019-01-16 |
| 1730654732 | Christine Gabriel | Registered Nurse | 3871 Cheryl Dr, Commerce Township, MI 48382-1723 | 2018-10-05 |
| 1730685132 | Daniel Kueppers | Registered Nurse | 3505 Denton Rd, Canton, MI 48188-2107 | 2018-04-04 |
| Find all providers with the same taxonomy | ||||
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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.