PAULETTE BAGNALL (NPI# 1972928646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972928646 |
| Entity Type | Individual |
| Full Name | PAULETTE BAGNALL |
| Credential | PA-C |
| Practice Address |
43525 Elizabeth St Mount Clemens MI 48043-1034 |
| Practice Telephone | 5864695491 |
| Mailing Telephone | 5864695491 |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-03-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601001994 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
43525 ELIZABETH ST |
| City | MOUNT CLEMENS |
| State | MI |
| Zip Code | 48043-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760462253 | County of Macomb | Public Health or Welfare | 43525 Elizabeth St, Mount Clemens, MI 48043-1034 | 2006-01-19 |
| 1568719094 | Jennifer Lenz | Nurse Practitioner | 43525 Elizabeth St, Mount Clemens, MI 48043-1034 | 2012-08-15 |
| 1366799165 | Barbara Jean Krauseneck | Nurse Practitioner | 43525 Elizabeth St, Mount Clemens, MI 48043-1034 | 2012-08-10 |
| 1528159258 | Kevin Paul Lokar | Preventive Medicine | 43525 Elizabeth St, Mount Clemens, MI 48043-1034 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| 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 |
|---|---|---|---|---|
| 1790254290 | Allyson R Hayman | Physician Assistant | 1030 Harrington St Ste Ll001, Mount Clemens, MI 48043-2918 | 2018-11-14 |
| 1841814373 | Amanda Rose Fillmore | Physician Assistant | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-06-01 |
| 1245854702 | Erynn Michelle Brown | Physician Assistant | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-06-01 |
| 1497314280 | Jonathan R Bartkus | Physician Assistant | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2019-06-06 |
| 1831674399 | Leena Kasmikha | Physician Assistant | 1030 Harrington St Ste 301, Mount Clemens, MI 48043-2967 | 2018-10-01 |
| 1043702129 | Maria Ramar | Physician Assistant | 175 N Groesbeck Hwy, Mount Clemens, MI 48043-1562 | 2018-06-04 |
| 1598277238 | Samantha Caramagno | Physician Assistant | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2017-11-03 |
| 1952849515 | Kayla N Monhollen | Physician Assistant | 1030 Harrington St Ste 301, Mount Clemens, MI 48043-2967 | 2017-02-03 |
| 1225406259 | Joseph Scherba | Physician Assistant | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-09-08 |
| 1073999629 | Nicole Marie Shields | Physician Assistant | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-08-05 |
| Find all providers in MOUNT CLEMENS | ||||
| City | MOUNT CLEMENS |
| Zip Code | 48043 |
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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.