KAITLYN ELIZABETH HEFFERAN (NPI# 1932455599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932455599 |
| Entity Type | Individual |
| Full Name | KAITLYN ELIZABETH HEFFERAN |
| Credential | PA |
| Practice Address |
28800 Ryan Rd Warren MI 48092-4272 |
| Practice Telephone | 5865582860 |
| Practice Fax Number | 5865584651 |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2019-05-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601006384 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 210 N Lafayette St, South Lyon, MI 481782048 | 2484655140 | 2484655141 |
| 26850 Providence Pkwy Ste 260, Novi, MI 483741256 | 2484655140 | 2484655141 |
| Street Address |
28800 RYAN RD |
| City | WARREN |
| State | MI |
| Zip Code | 48092-4272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710967815 | Gary G Gilyard | Orthopaedic Surgery | 28800 Ryan Rd, Suite 280, Warren, MI 48092-4272 | 2006-01-17 |
| 1982055943 | Melissa Wummel | Social Worker | 28800 Ryan Rd, Ste 320, Warren, MI 48092-4272 | 2016-06-30 |
| 1477920510 | Yasmin Keshavjee | Family Medicine | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2015-08-24 |
| 1033502224 | Neurocognitive Center of Michigan Group | Psychologist | 28800 Ryan Rd, Suite 300, Warren, MI 48092-4272 | 2015-03-11 |
| 1801207907 | Kathryn Aurand | Physician Assistant | 28800 Ryan Rd, Suite 280, Warren, MI 48092-4272 | 2014-05-12 |
| 1952721862 | Samantha Reichling | Specialist | 28800 Ryan Rd, Warren, MI 48092-4272 | 2014-04-17 |
| 1700204328 | Neurocognitive Center of Michigan Inc. | Psychologist | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2014-04-01 |
| 1487081782 | Sara Louise Blomeling-deroo | Social Worker | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2013-10-01 |
| 1275872376 | Dima Sprague | Physician Assistant | 28800 Ryan Rd, Warren, MI 48092-4272 | 2013-02-08 |
| 1568712370 | Behavioral Infermiera Care Solutions Inc | Psychologist | 28800 Ryan Rd, Suite 320, Warren, MI 48092-4272 | 2012-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163186 | Katherine Byrd | Behavior Technician | 3691 East 11 Mile Rd., Warren, MI 48092 | 2018-11-15 |
| 1861980302 | Mark Paul Azzo | Home Health Aide | 27605 Walker Ave, Warren, MI 48092 | 2018-04-30 |
| 1144747130 | Joseph Galutan Estrada | Chiropractor | 4846 Marlow Dr, Warren, MI 48092 | 2017-08-29 |
| 1649669425 | Lawrence Mosurak IIi | Chiropractor | 6201 Chicago Road, Warren, MI 48092 | 2015-01-15 |
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1487071999 | Michele Szandzik | Chiropractor | 2243 East 12 Mile Rd, Warren, MI 48092 | 2014-03-21 |
| 1962827311 | Mouradian Dental Center, D.d.s., P.C. | Dentist | 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 | 2014-02-21 |
| 1639495930 | Debra Kay Wenneman | Physical Therapist | 28776 Ryan Rd, Warren, MI 48092 | 2010-04-12 |
| 1922332923 | Sonia Amirali Pethani | Physical Therapist | 2117 E. Eleven Mile Rd., Warren, MI 48092 | 2009-09-23 |
| 1881822237 | Michael Patrick Walsh | Orthopaedic Surgery | 28800 Ryan Rd Ste 310, Warren, MI 48092 | 2009-06-24 |
| Find all providers in zip 48092 | ||||
| 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 |
|---|---|---|---|---|
| 1902421373 | Monique Mana | Physician Assistant | 28345 Marcia Ave, Warren, MI 48093-7209 | 2020-06-11 |
| 1790151264 | Mika Wexler Sachs | Physician Assistant | 11900 East 12 Mile Road, Suite 201, Warren, MI 48093 | 2015-08-19 |
| 1962832733 | Autumn Rancourt | Physician Assistant | 552 N Park Ave, Warren, OH 44481-1117 | 2013-11-15 |
| 1699012229 | Lynne Strachan | Physician Assistant | 28800 Ryan Rd Ste 320, Warren, MI 48092-4269 | 2013-01-16 |
| 1447508437 | Bradley L Grincewicz | Physician Assistant | 31700 Van Dyke Ave Ste 100, Warren, MI 48093-7951 | 2012-08-22 |
| 1821319633 | Lilana Lucaj | Physician Assistant | 26000 Hoover Rd Ste 102, Warren, MI 48089-1167 | 2010-06-15 |
| 1396071361 | Colleen Janness | Physician Assistant | 13450 East 12 Mile Rd, Advanced Dermatology of Michigan, PC, Warren, MI 48088 | 2009-10-27 |
| 1275768392 | Meghan Alice Haley | Physician Assistant | 3990 E. 12 Mile Rd., Warren, MI 48092 | 2009-05-19 |
| 1659555621 | Sakina Hakim | Physician Assistant | 28800 Ryan Road, Warren, MI 48092 | 2007-12-26 |
| 1699976464 | Kathleen O'reilly | Physician Assistant | 283 King George Rd, Warren, NJ 07059-5134 | 2007-05-30 |
| Find all providers in WARREN | ||||
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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.