DR. JESSICA NICOLE PASTVA (NPI# 1912524190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912524190 |
| Entity Type | Individual |
| Full Name | DR. JESSICA NICOLE PASTVA |
| Credential | DNP |
| Practice Address |
625 E Big Beaver Rd Ste 200 Troy MI 48083-1434 |
| Practice Telephone | 5868634000 |
| Practice Fax Number | 5868634004 |
| Mailing Telephone | 5868634000 |
| Mailing Fax Number | 5868634004 |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704362341 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
625 E BIG BEAVER RD STE 200 |
| City | TROY |
| State | MI |
| Zip Code | 48083-1434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770828121 | Paige Greaves | Social Worker | 625 E Big Beaver Rd Ste 200, Troy, MI 48083-1434 | 2012-12-11 |
| 1326699182 | Jaimmie Ilana Koss | Social Worker | 625 E Big Beaver Rd Ste 200, Troy, MI 48083-1434 | 2019-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033495643 | Jung Yoen Son | Nurse Practitioner | 2274 Golfview Dr, Apt 202, Troy, MI 48084-3848 | 2011-10-26 |
| 1619976388 | Andrea Nicole Kwasky | Nurse Practitioner | 1639 E Big Beaver Rd Ste 201, Troy, MI 48083-2054 | 2005-07-15 |
| 1356959316 | Daniel Grant Pecan | Nurse Practitioner | 2215 Burdett Ave, Troy, NY 12180-2475 | 2020-07-16 |
| 1740821958 | Kerri Lyn Outlaw | Nurse Practitioner | 1330 Highway 231 S, Troy, AL 36081-3058 | 2019-09-30 |
| 1003468273 | Kelly Lynne Mack | Nurse Practitioner | 2215 Burdett Ave, Troy, NY 12180-2466 | 2019-07-09 |
| 1487215604 | Michael Franz Dunker | Nurse Practitioner | 550 Summit Ave, Troy, OH 45373-3047 | 2019-06-27 |
| 1811435217 | Laurie Lavin | Nurse Practitioner | 2001 5th Ave, Troy, NY 12180-3482 | 2017-02-06 |
| 1245772292 | Jacquelyn Terry | Nurse Practitioner | 1639 E Big Beaver Rd Ste 201, Troy, MI 48083-2054 | 2016-11-08 |
| 1316329006 | Samantha Lynn Lucca | Nurse Practitioner | 2215 Burdett Ave, Troy, NY 12180-2466 | 2015-06-18 |
| 1033514930 | Sage College Welness Center - Troy | Nurse Practitioner | 65 1st St, Troy, NY 12180 | 2014-11-04 |
| Find all providers in TROY | ||||
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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.