STEPHANIE ANN BONENFANT (NPI# 1629592647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629592647 |
| Entity Type | Individual |
| Full Name | STEPHANIE ANN BONENFANT |
| Credential | PA-C |
| Practice Address |
600 Macinnes Dr Houghton MI 49931-1144 |
| Practice Telephone | 9064831180 |
| Practice Fax Number | 9064831815 |
| Mailing Telephone | 9064831180 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601008309 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
600 MACINNES DR |
| City | HOUGHTON |
| State | MI |
| Zip Code | 49931-1144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861463994 | Cynthia J. Blake | Nurse Practitioner | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2006-01-27 |
| 1487157103 | Monica Anne Aho | Physical Therapist | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2018-03-09 |
| 1619304615 | Portage Physician Practices Inc | Clinic/Center | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2013-10-04 |
| 1902126998 | Todd W Anderson | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2010-06-02 |
| 1619296894 | Paul Dennis Peterson | Pharmacist | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2010-05-27 |
| 1063748770 | Portage Health Inc. | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2009-10-30 |
| 1891942769 | Melissa A Vertin | Physician Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-08-22 |
| 1093979700 | Zachariah Matthew Deyoung | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-07-11 |
| 1982801569 | Karen Marie Deyoung | Family Medicine | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2007-06-28 |
| 1356475289 | Annette Kristiin Keranen | Physical Therapy Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2007-03-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962053447 | Meghan Lawler Immel | Counselor | 47431 St. Hwy M26 Unit 1, Suite 2, Houghton, MI 49931 | 2019-09-25 |
| 1205495710 | Public Counseling Services, LLC | Counselor | 47431 Hwy M26 Unit 1, Suite 2, Houghton, MI 49931 | 2019-06-08 |
| 1679047278 | Margiejo D Packham | Registered Nurse | 109 W Memorial Dr, Hancock, MI 49931 | 2019-01-16 |
| 1487150165 | Taylor Lee Douglas | Optometrist | 900 W Mem Dr, Houghton, MI 49931 | 2018-04-02 |
| 1033640867 | Larry Binoniemi | Pharmacist | 995 Razoback Dr, Houghton, MI 49931 | 2017-03-23 |
| 1013247972 | Portage Health Inc | General Practice | 921 W Sharon Ave., Houghton, MI 49931 | 2009-12-28 |
| 1508001629 | Aspirus Keweenaw | General Practice | 900 Memorial Drive, Houghton, MI 49931 | 2008-12-03 |
| 1306027057 | Gary Kilpela | Psychologist | 301 West Lake Ave., Suite 2, Houghton, MI 49931 | 2007-11-23 |
| 1811186455 | Baraga-houghton-keweenaw Child Development Board | Public Health or Welfare | 700 Park Avenue, Houghton, MI 49931 | 2007-10-19 |
| 1922294107 | Diane Sue Johnson | Registered Nurse | 901 West Memorial Drive, Houghton, MI 49931 | 2007-09-20 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700915345 | Shannon Isaacson | Physician Assistant | 921 W Sharon Ave, Houghton, MI 49931 | 2007-03-02 |
| 1891942769 | Melissa A Vertin | Physician Assistant | 600 Macinnes Dr, Houghton, MI 49931-1144 | 2008-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
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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.