KYRSTIN RACHAEL SEDLACEK (NPI# 1821604604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821604604 |
| Entity Type | Individual |
| Full Name | KYRSTIN RACHAEL SEDLACEK |
| Other Name | KYRSTIN ADAMS |
| Practice Address |
4020 Copper Vw Ste 104 Traverse City MI 49684-7041 |
| Mailing Address |
9041 Kingsfield Dr Kingsley MI 49649-8709 |
| Practice Telephone | 2314216921 |
| Mailing Telephone | 2316682792 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4704318300 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4020 COPPER VW STE 104 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-7041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427068790 | Sue Ellen Dunham | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684 | 2006-08-09 |
| 1447868153 | Deanna Humphrey | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2020-07-20 |
| 1841819521 | Sarah Crowley | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2020-04-13 |
| 1023669918 | Melanie Sue Lutz | Social Worker | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2019-09-23 |
| 1508419177 | Kari Ann Mark | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2019-07-22 |
| 1164085007 | Julie Krauth | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2019-04-16 |
| 1558839696 | Laura Ann Christopher | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2018-11-07 |
| 1407324601 | Amy Rasmussen | Dietitian, Registered | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2018-11-06 |
| 1013490663 | Karri G Hagan | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684 | 2018-09-10 |
| 1033690326 | Rebecca Louise Wiggins | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684-7041 | 2018-08-24 |
| Find all providers in the same location | ||||
| 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 Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871143685 | Shannon Marie Hicks | Nurse Practitioner | 1109 Randolph St, Traverse City, MI 49684-2122 | 2019-09-13 |
| 1780026849 | Jennifer Ann Marsh | Nurse Practitioner | 1221 Sixth St. Suite 300, Traverse City, MI 49684-2287 | 2013-07-17 |
| 1962597765 | Karen M Wagner | Nurse Practitioner | 5024 N Royal Drive, Traverse City, MI 49684 | 2006-10-04 |
| 1336258953 | Catherine Dilts Carter | Nurse Practitioner | 5024 N Royal Dr., Traverse City, MI 49684-9230 | 2006-08-29 |
| 1427068790 | Sue Ellen Dunham | Nurse Practitioner | 4020 Copper Vw Ste 104, Traverse City, MI 49684 | 2006-08-09 |
| 1366461121 | Mary Kay Williams | Nurse Practitioner | 1221 Sixth St Ste 306, Traverse City, MI 49684-2361 | 2006-07-19 |
| 1285690198 | Jeanette A Kalupa | Nurse Practitioner | 1014 Sixth St, Suite 103, Traverse City, MI 49684-2381 | 2006-04-21 |
| 1457913337 | Hannah M Popa | Nurse Practitioner | 1200 Sixth St, Ste 400, Traverse City, MI 49684-2369 | 2019-07-01 |
| 1669935003 | Lavinia Sinziana Streza | Nurse Practitioner | 1105 6th St, Traverse City, MI 49684-2345 | 2019-04-11 |
| 1861957037 | Michael Adam Gold | Nurse Practitioner | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2019-02-01 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.