MRS. BETTY ANN DORNBROOK (NPI# 1871695312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871695312 |
| Entity Type | Individual |
| Full Name | MRS. BETTY ANN DORNBROOK |
| Credential | NP |
| Practice Address |
2395 W Grand Blvd Detroit MI 48208-1210 |
| Mailing Address |
1352 Edmundton Dr Grosse Pointe Woods MI 48236-1027 |
| Practice Telephone | 3138972061 |
| Mailing Telephone | 3138828825 |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704088130 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2395 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48208-1210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992709331 | Professional Plaza Clinic Corporation | Legal Medicine | 2395 W Grand Blvd, Detroit, MI 48208-1210 | 2005-06-13 |
| 1184808966 | Ann Davis Garvin | Advanced Practice Midwife | 2395 W Grand Blvd, Detroit, MI 48208-1210 | 2007-12-28 |
| 1316088644 | Lisa Marie Randon | Pediatrics | 2395 W Grand Blvd, Detroit, MI 48208-1210 | 2007-02-09 |
| 1043369929 | David Alton Aprahamian | Family Medicine | 2395 W Grand Blvd, Detroit, MI 48208-1210 | 2007-01-09 |
| 1114097870 | Edna Ruth Jackson | Registered Nurse | 2395 W Grand Blvd, Detroit, MI 48208-1210 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1932645405 | Diane Louise Dodson | Counselor | 5500 Trumbull Apt 315, Detroit, MI 48208 | 2017-01-09 |
| 1164881306 | Cory Eugene Martin | Counselor | 1852 W. Grand Blvd., Detroit, MI 48208 | 2016-02-16 |
| 1578947784 | Hamza Belhaj | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-07-17 |
| 1942629167 | Diana Pool | Counselor | 3737 Lawton, Detroit, MI 48208 | 2014-04-15 |
| 1124467048 | Aisha Williams | Social Worker | 4707 Vinewood St., Detroit, MI 48208 | 2013-06-25 |
| 1295079895 | Mia Love | Nurse Practitioner | 2959 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2012-11-20 |
| 1992064356 | Valarie Egeria Foulks | Counselor | 2051 W. Grand Blvd, Detroit, MI 48208 | 2012-05-04 |
| 1023304078 | Ayana Njeri Davis | Massage Therapist | 2550 W. Grand Blvd, Detroit, MI 48208 | 2011-06-28 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| Find all providers in zip 48208 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205293057 | Karen Milana | Nurse Practitioner | 201 E Kirby St, Detroit, MI 48202-4048 | 2016-01-25 |
| 1568858793 | Michelle Wagner-smith | Nurse Practitioner | John D. Dingell Vamc, 4646 John R Street, Detroit, MI 48201-1916 | 2015-04-14 |
| 1477836419 | Helene June Krouse | Nurse Practitioner | 5557 Cass Ave, Cohn 146, Detroit, MI 48202-3615 | 2011-09-26 |
| 1639466055 | Wsu Physician Group | Nurse Practitioner | 4201 St. Antoine - University Health Center, Pod 5a, Detroit, MI 48201 | 2011-07-06 |
| 1356595441 | Danyelle Syvette Armour | Nurse Practitioner | 6001 W. Outer Drive, Suite 207, Detroit, MI 48235 | 2008-11-17 |
| 1023172699 | Theresa Marie Cirocco | Nurse Practitioner | 2799 W Grand Blvd Rm E235, Detroit, MI 48202-2608 | 2006-12-20 |
| 1336226422 | Naima Latriese Ogletree | Nurse Practitioner | 2799 W Grand Blvd # Cfp-547, Detroit, MI 48202-2608 | 2006-11-01 |
| 1982642054 | Kelly K Wietecha | Nurse Practitioner | Harper Professional Bldg Ste 1007, 4160 John R, Detroit, MI 48201 | 2006-06-02 |
| 1023055019 | Lisa Binns-emerick | Nurse Practitioner | 4201 St Antoine Ste 5b, Drh Rosa Parks Wellness Institute for Sr Health, Detroit, MI 48201 | 2006-05-31 |
| 1104863000 | Rebecca Hunnicutt Farren | Nurse Practitioner | Childrens Hospital Mi Pediatric Administration, 3901 Beaubien, Detroit, MI 48201 | 2006-05-31 |
| 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.