MR. CRAIG BROCKMAN (NPI# 1639174071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639174071 |
| Entity Type | Individual |
| Full Name | MR. CRAIG BROCKMAN |
| Credential | N.P. |
| Practice Address |
11775 Tecumseh Clinton Rd Clinton MI 49236-9541 |
| Mailing Address |
8770 Hawthorne Dr Tecumseh MI 49286-9504 |
| Practice Telephone | 5174567449 |
| Practice Fax Number | 5174566059 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2013-03-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704166180 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023188760 | Craig Reece Brockman II | Emergency Medicine | 231 South Collins, Sunnyvale, TX 75182-4624 | 2006-11-09 |
| Street Address |
11775 TECUMSEH CLINTON RD |
| City | CLINTON |
| State | MI |
| Zip Code | 49236-9541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538691480 | Adam Kosteva | Family Medicine | 11775 Tecumseh Clinton Rd, Clinton, MI 49236-9541 | 2017-03-30 |
| 1073807665 | Jeffrey A. Mendoza | Family Medicine | 11775 Tecumseh Clinton Rd, Clinton, MI 49236-9541 | 2011-06-01 |
| 1811288103 | Sarah Kaminsky | Family Medicine | 11775 Tecumseh Clinton Rd, Clinton, MI 49236-9541 | 2011-04-21 |
| 1316256241 | Matthew David Bruce | Family Medicine | 11775 Tecumseh Clinton Rd, Clinton, MI 49236-9541 | 2010-09-27 |
| 1518193259 | Sreevalli Attili | Family Medicine | 11775 Tecumseh Clinton Rd, Clinton, MI 49236-9541 | 2009-06-09 |
| 1992852594 | Iha Health Services Corporation | Internal Medicine | 11775 Tecumseh Clinton Rd, Clinton, MI 49236-9541 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790976884 | Wendy A. Jativa | Dentist | 147 West Michigan Ave, Clinton, MI 49236 | 2007-08-05 |
| 1568682938 | Dennis Richard Kaechele | Dentist | 1671 West Us Hwy 12, Suite B, Clinton, MI 49236 | 2007-04-26 |
| 1073641817 | Thomas Anthony Pinard | Chiropractor | 1671 W Michigan Ave Ste A-2, Clinton, MI 49236 | 2007-03-02 |
| 1720125842 | Jan M Rizzo Dds PC | Clinic/Center | 147 West Michigan Avenue, Clinton, MI 49236 | 2007-01-30 |
| 1184711699 | Schmidt & Sons Pharmacy of Clinton Inc | Durable Medical Equipment & Medical Supplies | 140 W. Michigan Ave., Clinton, MI 49236 | 2006-10-06 |
| 1518059765 | Per Okey | Family Medicine | 301 W. Franklin Street, Clinton, MI 49236 | 2006-09-28 |
| 1770870479 | Susan Mullinix | Physical Therapist | 1671 W Michigan Ave, Ste D, Clinton, MI 49236 | 2011-07-01 |
| 1720103997 | Thomas Steven Kosmyna | Chiropractor | 301 W Michigan Ave, Clinton, MI 49236 | 2007-03-20 |
| 1356328124 | Laurie Boyd | Nurse Practitioner | 1671 W Michigan Ave, Suite A, Clinton, MI 49236-8702 | 2005-12-22 |
| 1164996344 | Pinard Chiropractic | Chiropractor | 1671 W Michigan Ave Ste A-2, Clinton, MI 49236-8702 | 2019-01-22 |
| Find all providers in zip 49236 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463300 | Sheryl Punzal Deguzman-buenaventura | Nurse Practitioner | 12410 Hillantrae Dr, Clinton, MD 20735-6510 | 2020-09-25 |
| 1003426396 | Rollie Stewart Walker | Nurse Practitioner | 114 Riverview Dr, Clinton, OK 73601-1805 | 2020-08-03 |
| 1316585813 | Sherkeysha Henderson | Nurse Practitioner | 106 Rosalie Ct, Clinton, MS 39056-6053 | 2019-12-16 |
| 1528600707 | Allison Maddox | Nurse Practitioner | 7506 Abelia Dr, Clinton, MD 20735-3135 | 2019-10-09 |
| 1205486347 | Elizabeth Oti | Nurse Practitioner | 313 Park Edge Dr, Clinton, PA 15026-1785 | 2019-09-19 |
| 1326609074 | Lauren Blakley | Nurse Practitioner | 2130 N Charles G Seivers Blvd Ste 3, Clinton, TN 37716-6705 | 2019-06-24 |
| 1346807443 | Karen Daniels | Nurse Practitioner | 2701 Frienship Trl, Apt 1001, Clinton, IA 52732 | 2019-05-23 |
| 1205490380 | Cynthia Diane Saylors | Nurse Practitioner | 64 Somerset Dr, Clinton, IL 61727-2478 | 2019-04-24 |
| 1720546864 | Lesley Brooke Keith | Nurse Practitioner | 422 Highway 95 E, Clinton, AR 72031-6947 | 2019-03-07 |
| 1578020822 | Caroline V Green | Nurse Practitioner | 768 Cherry Stone Dr, Clinton, MS 39056-2015 | 2019-02-22 |
| Find all providers in CLINTON | ||||
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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.