PATRICIA MCKINNIN/SANDRIDGE (NPI# 1780075705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780075705 |
| Entity Type | Individual |
| Full Name | PATRICIA MCKINNIN/SANDRIDGE |
| Practice Address |
2939 Russell St Detroit MI 48207-4825 |
| Practice Telephone | 3133965300 |
| Practice Fax Number | 3133965353 |
| Mailing Telephone | 3133965300 |
| Mailing Fax Number | 3133965353 |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
4704125683 | MI | Nursing Service Providers |
| Street Address |
2939 RUSSELL ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-4825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881679355 | Margo Kimberlee Ferguson | Family Medicine | 2939 Russell St, Detroit, MI 48207-4825 | 2005-12-07 |
| 1962869081 | Venecya Latonya Gavin | Social Worker | 2939 Russell St, Detroit, MI 48207-4825 | 2016-01-20 |
| 1043686215 | Samah Abdul Altairi | Social Worker | 2939 Russell St, Detroit, MI 48207-4825 | 2015-08-11 |
| 1114303740 | Ngozi Eke | Social Worker | 2939 Russell St, Detroit, MI 48207-4825 | 2015-08-05 |
| 1457735524 | Krystle Nicole Carter | Case Manager/Care Coordinator | 2939 Russell St, Detroit, MI 48207-4825 | 2015-07-17 |
| 1770966368 | Team Wellness Center | Case Management | 2939 Russell St, Detroit, MI 48207-4825 | 2015-07-01 |
| 1255727921 | Michael John Allen | Registered Nurse | 2939 Russell St, Detroit, MI 48207-4825 | 2015-04-09 |
| 1518350404 | Laporsche Smith | Case Manager/Care Coordinator | 2939 Russell St, Detroit, MI 48207-4825 | 2015-03-16 |
| 1316338841 | Tiffany Black | Social Worker | 2939 Russell St, Detroit, MI 48207-4825 | 2015-02-05 |
| 1225429756 | Karianta Hobbs | Social Worker | 2939 Russell St, Detroit, MI 48207-4825 | 2015-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346755972 | Mark Christoper Tanario | Registered Nurse | 1221 E Grand Blvd, Detroit, MI 48211-3428 | 2017-12-05 |
| 1306012778 | Sharon Denise Pittman | Registered Nurse | 5555 Conner St Ste 1000, Detroit, MI 48213-3448 | 2008-05-05 |
| 1710526629 | Johanna Joyce Deleon | Registered Nurse | 6309 Mack Ave, Detroit, MI 48207-2302 | 2019-12-26 |
| 1295372555 | Nausheen None Habib | Registered Nurse | 2925 Russell St, Detroit, MI 48207-4825 | 2019-12-05 |
| 1497263982 | Erica Perryman | Registered Nurse | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2018-01-18 |
| 1730697830 | Jamie Wood | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-11 |
| 1194265108 | Lauren Yvette Campbell-perry | Registered Nurse | 24424 W Mcnichols Rd, Detroit, MI 48219-3653 | 2017-02-24 |
| 1225403827 | Dawn M. Pierzhala | Registered Nurse | 12800 E Warren Ave, Detroit, MI 48215-2061 | 2015-12-08 |
| 1497155501 | Yolanda James | Registered Nurse | 11457 Shoemaker St, Detroit, MI 48213-3418 | 2014-08-26 |
| 1457774382 | Angie Glosson | Registered Nurse | 12800 E Warren Ave, Detroit, MI 48215-2061 | 2014-01-29 |
| Find all providers in DETROIT | ||||
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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.