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