SUSAN MARIE WASSENHOVE (NPI# 1861420341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861420341 |
| Entity Type | Individual |
| Full Name | SUSAN MARIE WASSENHOVE |
| Credential | PA-C |
| Practice Address |
812 W 4th St Mishawaka IN 46544-1738 |
| Mailing Address |
812 W 4th Street Mishawaka IN 46544 |
| Practice Telephone | 5742551604 |
| Mailing Telephone | 5742551604 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2011-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 1722 | AK | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | 4398 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2692-23, | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363A00000X | Physician Assistant | 5601001412 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
812 W 4TH ST |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544-1738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
| Find all providers in zip 46544 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548805633 | Haley Nichole Jackson | Physician Assistant | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 | 2019-11-12 |
| 1881161214 | Alexi Bellchambers | Physician Assistant | 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 | 2018-10-24 |
| 1164909172 | Madeline Louise Ryan | Physician Assistant | 611 E Douglas Rd Ste 208, Mishawaka, IN 46545-1465 | 2018-07-23 |
| 1750316196 | John L Kittredge | Physician Assistant | 3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3474 | 2006-07-12 |
| 1982635587 | Nicole Leigh Fornalik | Physician Assistant | 5340 Holy Cross Pkwy, Mishawaka, IN 46545-1470 | 2006-07-05 |
| 1427001742 | David Eugene Fellows | Physician Assistant | 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545-1469 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133894 | Kaylin Michelle Lapel | Physician Assistant | 1540 Orchard Park Dr N, Carmel, IN 46280-1513 | 2020-11-01 |
| 1639779739 | Brock Sokolowski | Physician Assistant | 4581 Nikki Dr Apt D, Indianapolis, IN 46237-1703 | 2020-10-28 |
| 1699373357 | Dillon Etter | Physician Assistant | 2848 N Delaware St, Indianapolis, IN 46205-4118 | 2020-10-15 |
| 1417555996 | Kathleen Wiles | Physician Assistant | 3805 Pine Creek Cir, New Albany, IN 47150-2057 | 2020-10-15 |
| 1962017210 | Taylor Lee Bowen | Physician Assistant | 2760 Woodwind Way, Indianapolis, IN 46268-4233 | 2020-09-14 |
| 1275148421 | James Cameron Fields | Physician Assistant | 532 Bridgestone Dr, Mooresville, IN 46158-7304 | 2020-09-14 |
| 1912512476 | William Terrell Parmenter | Physician Assistant | 2230 English Ave, Indianapolis, IN 46201-4017 | 2020-09-11 |
| 1457966376 | Angela Shearon | Physician Assistant | 4325 N College Ave, Indianapolis, IN 46205-1931 | 2020-09-09 |
| 1831702570 | Nathan Dean Hailey | Physician Assistant | 1115 Ronald Reagan Pkwy Ste 247, Avon, IN 46123-6911 | 2020-08-24 |
| 1104438944 | Erin R Griffin | Physician Assistant | 5621 Woodshire Dr Apt 5, Fort Wayne, IN 46835-2959 | 2020-08-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SUSAN MARIE WASSENHOVE.
| 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.