KIMBERLY ANN DUNLEAVY (NPI# 1811373384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811373384 |
| Entity Type | Individual |
| Full Name | KIMBERLY ANN DUNLEAVY |
| Other Name | KIMBERLY ANN KEPPEN |
| Credential | NP |
| Practice Address |
15555 Northline Rd Southgate MI 48195-1896 |
| Practice Telephone | 7342853090 |
| Practice Fax Number | 7342853095 |
| Mailing Telephone | 7342853090 |
| Mailing Fax Number | 7342853095 |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2016-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
4704289989 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
15555 NORTHLINE RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-1896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568430502 | Dinesh Nayak | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2006-03-08 |
| 1417554106 | Adriana Elise Smith | Nurse Practitioner | 15555 Northline Rd, Southgate, MI 48195-1896 | 2020-10-06 |
| 1386186930 | Brenden Bisson | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2016-11-14 |
| 1770779589 | Zeeshan Tarique | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2007-09-15 |
| 1568545077 | Lakshmi Hanasoge | Pediatrics | 15555 Northline Rd, Southgate, MI 48195-1896 | 2006-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554106 | Adriana Elise Smith | Nurse Practitioner | 15555 Northline Rd, Southgate, MI 48195-1896 | 2020-10-06 |
| 1124594288 | Christina M Ralko | Nurse Practitioner | 15350 Trenton Rd, Southgate, MI 48195-2027 | 2018-10-16 |
| 1003246380 | Brooke Nayak | Nurse Practitioner | 15255 Northline Rd, Southgate, MI 48195-2487 | 2013-11-22 |
| 1114064698 | Deborah Jane Collier-barstad | Nurse Practitioner | 15255 Northline Rd, Southgate, MI 48195-2487 | 2007-01-31 |
| 1639119084 | Jennifer Beswick | Nurse Practitioner | 15777 Northline Rd, Southgate, MI 48195-2385 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991061 | Sarah Elizabeth Barber | Nurse Practitioner | 12918 Lake Point Pass, Van Buren Twp, MI 48111-2243 | 2020-10-27 |
| 1730700881 | Kelsey Olinik | Nurse Practitioner | 22200 Barclay Dr, Novi, MI 48374-3874 | 2020-04-29 |
| 1467080705 | Jessica Nicole Heichel | Nurse Practitioner | 7729 Brass Creek Ct, Dexter, MI 48130-9384 | 2020-03-31 |
| 1114550506 | Katlyn Roberts | Nurse Practitioner | 60160 E 8 Mile Rd, South Lyon, MI 48178-9768 | 2020-02-13 |
| 1093351595 | Emily Janina Jamett | Nurse Practitioner | 31815 Southfield Rd Ste 10, Beverly Hills, MI 48025-5471 | 2019-11-20 |
| 1508410747 | Clorissa Diedrich | Nurse Practitioner | 829 N Center Ave Ste 130, Gaylord, MI 49735-1684 | 2019-07-25 |
| 1255895355 | Jessica Lynn Kata | Nurse Practitioner | 19229 Mack Ave Ste 28, Grosse Pointe Woods, MI 48236-2857 | 2019-01-23 |
| 1467934679 | Anita Lynn Riddle | Nurse Practitioner | 100 W. Vanburen Street, Battle Creek, MI 49017 | 2018-09-04 |
| 1285120634 | Alexandra Danko | Nurse Practitioner | 5500 Auto Club Dr Ste 160, Dearborn, MI 48126-2779 | 2018-07-09 |
| 1417442617 | Shelby Fredricks | Nurse Practitioner | 1205 S Mission St Ste 4, Mount Pleasant, MI 48858-3939 | 2018-06-29 |
| Find all providers with the same taxonomy | ||||
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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.