MRS. LYNN REDDEN SHATTUCK


Address: 2828 Concord St, Traverse City, MI 49684-4618
Phone: 2313466930

MRS. LYNN REDDEN SHATTUCK (NPI# 1679556724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679556724
Entity Type Individual
Full Name MRS. LYNN REDDEN SHATTUCK
Credential NP
Practice Address 2828 Concord St
Traverse City
MI 49684-4618
Mailing Address 10850 E Traverse Hwy
Ste 4400
Traverse City
MI 49684-1364
Practice Telephone 2313466930
Mailing Telephone 2313466800
Mailing Fax Number 2313466017
Enumeration Date 2005-11-22
Last Update Date 2016-02-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
4704295437 MI Physician Assistants & Advanced Practice Nursing Providers
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
102054 NC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2828 CONCORD ST
City TRAVERSE CITY
State MI
Zip Code 49684-4618

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700266780 Traverse City Opco, LLC Skilled Nursing Facility 2828 Concord St, Traverse City, MI 49684-4618 2015-06-04
1043649684 Ann Marie Schoenborn Physical Therapy Assistant 2828 Concord St, Traverse City, MI 49684-4618 2013-11-04
1801190335 Jennifer Keene Occupational Therapist 2828 Concord St, Traverse City, MI 49684-4618 2010-12-23
1336226752 Traverse Geriatric Village, Inc Skilled Nursing Facility 2828 Concord St, Traverse City, MI 49684-4618 2006-11-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124641758 Karen Anne Paulosky Registered Nurse 226 S Madison St, Traverse City, MI 49684 2020-05-18
1891314795 Jaclyn Elizabeth Sylvain Student in an Organized Health Care Education/Training Program Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 2020-04-10
1285282988 Madelyn Drumm Dietitian, Registered 217 S. Madison St., Suite 3022, Traverse City, MI 49684 2019-08-27
1265917686 Kacie Danielle Heading Social Worker 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 2018-10-02
1881178325 Jacob White Ph.d., Pllc Psychologist 3537 W. Front Street, Suite F, Traverse City, MI 49684 2018-09-20
1144702572 Constance Baab, Phd, Lmsw, Pllc Social Worker 3301 Veterans Drive Suite 127, Traverse City, MI 49684 2018-09-01
1346732880 The Skin Cancer and Dermatology Center Plc Dermatology 1225 W Front St Ste 2, Traverse City, MI 49684 2018-05-31
1790283851 Lisa Louise Kleyps Massage Therapist 3337 W. South Airport Road #2, Traverse City, MI 49684 2018-01-24
1114447646 Brittany Alexandra Prior Physical Therapist 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 2017-06-26
1568902963 Jennifer Scott Behavior Technician 515 W 14th St Unit D, Traverse City, MI 49684 2017-03-03
Find all providers in zip 49684

Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316464019 Ali Razak Salman Saheb Nurse Practitioner 9711 E Walters Dr, Traverse City, MI 49684-7611 2017-08-24
1649345463 Patricia Anne Friedli Nurse Practitioner 2600 Lafranier Rd Ste A, Traverse City, MI 49686-4765 2006-11-21
1164085007 Julie Krauth Nurse Practitioner 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 2019-04-16
1023501699 Jessica Mastbergen Nurse Practitioner 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 2018-06-08
1326544230 Kaitlyn Troutman Nurse Practitioner 550 Munson Ave, Traverse City, MI 49686-3580 2018-04-02
1730550559 Nichole Kelenske Nurse Practitioner 10850 E Traverse Hwy, Suite 4400, Traverse City, MI 49684-1364 2015-10-20
1255702999 Melissa Schaub Nurse Practitioner 10850 E Traverse Hwy, Suite 4400, Traverse City, MI 49684-1364 2015-10-07
1245522994 Alison Balmer Quiring Nurse Practitioner 1221 Sixth St Ste 208, Traverse City, MI 49684-2360 2011-05-12
1316278765 Dorothy Catherine Low Nurse Practitioner 2585 Lafranier Rd, Traverse City, MI 49686-8972 2010-01-25
1427247642 Kori Lyn Woodruff Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2007-10-24
Find all providers in TRAVERSE CITY

Competitor

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City TRAVERSE CITY
Zip Code 49684

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Dataset Information

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.

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