MATTHEW MICHAEL JACQUE (NPI# 1730710393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730710393 |
| Entity Type | Individual |
| Full Name | MATTHEW MICHAEL JACQUE |
| Practice Address |
303 E Kearsley St Flint MI 48502-1907 |
| Mailing Address |
5525 Millington Rd Millington MI 48746-9538 |
| Practice Telephone | 8107623000 |
| Mailing Telephone | 8102109502 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
303 E KEARSLEY ST |
| City | FLINT |
| State | MI |
| Zip Code | 48502-1907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831402684 | Urban Health and Wellness Center | Clinic/Center | 303 E Kearsley St, 1153 William S. White Building, Flint, MI 48502-1907 | 2010-07-22 |
| 1093355091 | Brittany Marie Fischer | Registered Nurse | 303 E Kearsley St, Flint, MI 48502-1907 | 2020-01-08 |
| 1144866963 | Jennifer Tempest | Nurse Practitioner | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-27 |
| 1841836582 | Kelly Holda | Nurse Anesthetist, Certified Registered | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-18 |
| 1750927497 | Nicole Lucas | Registered Nurse | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-18 |
| 1669018305 | Jason Scholten | Nurse Anesthetist, Certified Registered | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-18 |
| 1295371938 | Andrew Michael Deneen | Nurse Anesthetist, Certified Registered | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-18 |
| 1104462845 | Zachary Westveer | Nurse Anesthetist, Certified Registered | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-18 |
| 1013553759 | James Steven Buster | Nurse Anesthetist, Certified Registered | 303 E Kearsley St, Flint, MI 48502-1907 | 2019-11-18 |
| 1922644665 | Jessica Ford | Nurse Anesthetist, Certified Registered | 303 E Kearsley St, Flint, MI 48502 | 2019-11-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003453267 | Patricia Ann Love | Peer Specialist | Training& Treatment Innovations,inc, 929 Stevenson St, Flint, MI 48502 | 2019-12-06 |
| 1104474329 | First Trinity Missionary Baptist Church | Public Health or Welfare | 1226 Beach St, Flint, MI 48502 | 2019-08-30 |
| 1851861447 | Mia Riggs | Peer Specialist | 932 Beach St., Flint, MI 48502 | 2018-11-27 |
| 1366948937 | Stephanie Laverne Mcgowan | Counselor | 129 E. Third Street, Flint, MI 48502 | 2018-04-03 |
| 1801304498 | Faith Ellen Gardner | Student in an Organized Health Care Education/Training Program | 529 Mlk, Flint, MI 48502 | 2018-01-17 |
| 1154857423 | Carolyn Denise Scott | Counselor | 529 M.l. King, Jr. Ave., Flint, MI 48502 | 2017-05-05 |
| 1922556406 | Kenya Hameed | Clinical Neuropsychologist | 111 East Court St, Suite 1b-1, Flint, MI 48502 | 2016-09-14 |
| 1518319367 | Leann Littlejohn | Counselor | 529 Ml King Ave., Flint, MI 48502 | 2016-07-05 |
| 1093185712 | Jayme Gene Wagner | Counselor | 529 M. L. King, Jr. Ave, Flint, MI 48502 | 2015-10-07 |
| 1508260753 | Brittany Hopkins | Counselor | 529 Marting Luther King Jr Ave, Flint, MI 48502 | 2014-10-17 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487262978 | Sajidmiahejiah Issachar Ramsey | Student in an Organized Health Care Education/Training Program | 812 Root St Fl 2, Flint, MI 48503-1516 | 2020-07-21 |
| 1265051858 | Yandy Rodriguez Orozco | Student in an Organized Health Care Education/Training Program | 2900 N Saginaw Rd, Flint, MI 48505-4452 | 2020-04-13 |
| 1194351130 | Alexander Raouf Mikhail | Student in an Organized Health Care Education/Training Program | 1299 Hickory Hollow Dr, Flint, MI 48532-2036 | 2020-03-22 |
| 1336794429 | Mousa Gomaa Eissa | Student in an Organized Health Care Education/Training Program | 2 Hurley Plz Ste 101, Flint, MI 48503-5904 | 2019-08-06 |
| 1871146423 | Tasheikya Hunter | Student in an Organized Health Care Education/Training Program | 6004 Lancaster Dr, Flint, MI 48532-3213 | 2019-07-23 |
| 1134781198 | Abdelrahman Assem Hammat Yousif | Student in an Organized Health Care Education/Training Program | 1 Hurley Plz Ste 101, Flint, MI 48503-5902 | 2019-06-30 |
| 1598324329 | Santosh Kumar Dhungana | Student in an Organized Health Care Education/Training Program | 2 Hurley Plz Ste 2, Flint, MI 48503-5903 | 2019-06-05 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1174027270 | Jennifer Tripp | Student in an Organized Health Care Education/Training Program | 111 E Court St Ste 1b-1, Flint, MI 48502-1600 | 2018-03-22 |
| 1801304498 | Faith Ellen Gardner | Student in an Organized Health Care Education/Training Program | 529 Mlk, Flint, MI 48502 | 2018-01-17 |
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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.