KELLY K WIETECHA


Address: Harper Professional Bldg Ste 1007, 4160 John R, Detroit, MI 48201
Phone: 3137454525

KELLY K WIETECHA (NPI# 1982642054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1982642054
Entity Type Individual
Full Name KELLY K WIETECHA
Credential CNP
Practice Address Harper Professional Bldg Ste 1007
4160 John R
Detroit
MI 48201
Mailing Address 3800 Woodward Ave
Suite 702
Detroit
MI 48201-2061
Practice Telephone 3137454525
Enumeration Date 2006-06-02
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
4704176683 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address HARPER PROFESSIONAL BLDG STE 1007
4160 JOHN R
City DETROIT
State MI
Zip Code 48201

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659989838 Saima Sharif Student in an Organized Health Care Education/Training Program 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 2020-07-14
1609494384 Praveen Kumar Boddu Student in an Organized Health Care Education/Training Program 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 2020-07-09
1730707720 Amr Hassan Abdelghaffar Omar Pediatrics 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 2020-07-07
1700400694 Hassan Imtiaz Student in an Organized Health Care Education/Training Program 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 2020-06-05
1598389074 Alaa Awad Elkarim Student in an Organized Health Care Education/Training Program 3901 Beaubien St. 3t72, Detroit, MI 48201 2020-06-01
1891319299 Jeongyeon Hwang Student in an Organized Health Care Education/Training Program 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 2020-06-01
1477176576 Jaudat Fatima Masood Student in an Organized Health Care Education/Training Program 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 2020-05-22
1205459419 Amit Kumar Dahiya Student in an Organized Health Care Education/Training Program 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 2020-05-21
1851914188 Asra Nausheen Shaik Student in an Organized Health Care Education/Training Program 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 2020-05-21
1568085751 Camille Olechowski Student in an Organized Health Care Education/Training Program 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 2020-05-21
Find all providers in zip 48201

Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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
1881681955 Patricia Barszenski Nurse Practitioner 7733 E Jefferson Ave, 1350, Detroit, MI 48214-3707 2005-10-04
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City DETROIT
Zip Code 48201

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Dataset Information

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.

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