JESSICA RENEE SAMUELSON (NPI# 1730731829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730731829 |
Entity Type | Individual |
Full Name | JESSICA RENEE SAMUELSON |
Other Name | JESSICA RENEE THICK |
Credential | DNP FNP-BC |
Practice Address |
3400 Fleckenstein Rd Flint MI 48507-3042 |
Mailing Address |
1639 Farnsworth Rd Lapeer MI 48446-8711 |
Practice Telephone | 8103582902 |
Mailing Telephone | 8103582902 |
Enumeration Date | 2019-07-10 |
Last Update Date | 2020-06-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704313451 | MI | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
44405 Woodward Ave, Pontiac, MI 483415023 | 2482946700 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750630851 | Jessica Samuelson | Psychologist | 1680 E Gude Dr, Rockville, MD 20850-1360 | 2012-09-05 |
Street Address |
3400 FLECKENSTEIN RD |
City | FLINT |
State | MI |
Zip Code | 48507-3042 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083688725 | Kazem Hak | Internal Medicine | 3400 Fleckenstein Rd, Suite 3, Flint, MI 48507-3043 | 2006-02-16 |
1538606546 | Dayna Rae-edgerton Timmreck | Nurse Practitioner | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2017-01-28 |
1811386527 | Evolution Imaging | Radiology | 3400 Fleckenstein Rd, Suite C, Flint, MI 48507-3042 | 2015-01-19 |
1114328861 | Medquest Imaging L.l.c | Physiological Laboratory | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2014-09-12 |
1801209549 | Comprehensive Pain Specialists, Pllc | Pain Medicine | 3400 Fleckenstein Rd, Suite 1, Flint, MI 48507-3042 | 2014-06-10 |
1255696092 | Douglas Joseph Boven II | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Flint, MI 48507-3042 | 2012-07-09 |
1659664092 | Bps-sar Pllc | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Suite 4, Flint, MI 48507-3042 | 2011-05-18 |
1265687321 | Millenium North PC | Internal Medicine | 3400 Fleckenstein Rd, Suite 3, Flint, MI 48507-3043 | 2008-11-17 |
1760638241 | Mid Michigan Diagnostic Corp | Radiology | 3400 Fleckenstein Rd, Suite D, Flint, MI 48507-3043 | 2008-08-15 |
1124225255 | Carlo E Adams | Physical Medicine & Rehabilitation | 3400 Fleckenstein Rd, Suite 1, Flint, MI 48507-3042 | 2007-07-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245847870 | Alexis Nichole Leach | Physician Assistant | 5494 South Dort Hwy, Flint, MI 48507 | 2020-09-28 |
1508330317 | Jeffrey Mark Funck | Registered Nurse | G-4443 Miller Road, Suite 100, Flint, MI 48507 | 2019-01-15 |
1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
1760984348 | Melissa Dawn Hoffman | Psychologist | 5402 Gateway Centre Drive, Suite B, Flint, MI 48507 | 2018-02-28 |
1902327323 | Katee Mast | Case Manager/Care Coordinator | 110 Eldon Baker Drive, Flint, MI 48507 | 2017-07-06 |
1699228460 | Joshua Sinclair | Social Worker | 2442 E Maple Ave Ste 207, Flint, MI 48507 | 2016-07-28 |
1477903730 | Gracie Hunter | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1110 Eldon Baker, Flint, MI 48507 | 2016-06-17 |
1528412822 | Drita Gojcaj | Massage Therapist | 3426 Miller Road, Flint, MI 48507 | 2016-04-22 |
1629422100 | Ellen Makarewicz-ely | Massage Therapist | 3426 Miller Rd, Flint, MI 48507 | 2016-04-20 |
1700262722 | Katelyn Bailey | Nurse Practitioner | 1420 W Twelfth St, Flint, MI 48507 | 2015-07-31 |
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Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831739523 | Tiffany M Stafford | Nurse Practitioner | 5536 S Saginaw Rd, Flint, MI 48507-4421 | 2020-01-09 |
1184269599 | Tamela Renae Callahan | Nurse Practitioner | 20188 Ridgerock Dr, Flint, TX 75762-9335 | 2019-11-08 |
1164982229 | Randi Lynn Ballard-dickerson | Nurse Practitioner | 1140 S Linden Rd Bldg A, Flint, MI 48532-3437 | 2019-03-23 |
1710454111 | Brian Mcdermott | Nurse Practitioner | 1230 S Linden Rd Ste 4, Flint, MI 48532-3424 | 2018-10-24 |
1861981292 | Lavonne L Alexander | Nurse Practitioner | 4500 S Saginaw St Ste 1875, Flint, MI 48507 | 2018-05-01 |
1144728593 | Matthew Thomas Evans | Nurse Practitioner | 1125 S Linden Rd Ste 900, Flint, MI 48532-4068 | 2018-01-30 |
1093213977 | Sandy Holland | Nurse Practitioner | 4100 Beecher Road, Flint, MI 48532-2819 | 2018-01-25 |
1245760883 | Melinda Sue Williams | Nurse Practitioner | 2304 Bradford Dr, Flint, MI 48507-4404 | 2017-06-15 |
1912340332 | Patricia Ann Ward | Nurse Practitioner | 1401 E. Court, Mott Community College Health Services, Flint, MI 48503 | 2013-04-16 |
1710119904 | Laura Lea Szakal | Nurse Practitioner | 1386 S Linden Rd, Flint, MI 48532-4185 | 2009-08-20 |
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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.