Jaclyn J Brothers (NPI# 1619397601, PAC ID# 6507080264) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1619397601 |
| PAC ID by PECOS | 6507080264 |
| Professional Enrollment ID | I20140619001166 |
| Full Name | Jaclyn J Brothers |
| Organization Legal Name | ELIZABETH LAKE URGENT CARE PLLC |
| Address |
2446 Elizabeth Lake Rd Waterford MI 48328-3310 |
| Phone Number | 2483093344 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3375769078 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230130 | BEAUMONT HOSPITAL, ROYAL OAK |
| Address | Phone | Organization |
|---|---|---|
| 57850 Van Dyke Rd, Suite 100, Washington Township, MI 48094-3821 | 5869354000 | WASHINGTON URGENT CARE PLLC |
| 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 | 2483093344 | ELIZABETH LAKE URGENT CARE PLLC |
| Organization Legal Name | ELIZABETH LAKE URGENT CARE PLLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle Elliott | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Stacey L Rudy | Physician Assistant | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Jennifer M Crosby | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Lisa M Jensen | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Andrew Damaske | Family Medicine | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Ashley N Hindo | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Fadi Demashkieh | Internal Medicine | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| David Atkins | Physician Assistant | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Shafiqul Alam | Internal Medicine | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Justin Crane | Physician Assistant | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Street Address |
2446 ELIZABETH LAKE RD |
| City | WATERFORD |
| State | MI |
| Zip | 48328-3310 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle Elliott | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Stacey L Rudy | Physician Assistant | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Jennifer M Crosby | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Lisa M Jensen | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Andrew Damaske | Family Medicine | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Ashley N Hindo | Nurse Practitioner | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Fadi Demashkieh | Internal Medicine | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| David Atkins | Physician Assistant | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Shafiqul Alam | Internal Medicine | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Justin Crane | Physician Assistant | Elizabeth Lake Urgent Care Pllc | 2446 Elizabeth Lake Rd, Waterford, MI 48328-3310 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Indira J Hall | Clinical Social Worker | 4523 Highland Rd, Waterford, MI 48328-1132 | |
| Faris P Atchoo | Internal Medicine | 4511 Highland Rd, Waterford, MI 48328-1132 | |
| Philip T Schmitt | Orthopedic Surgery | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Richard Steven Bartholomew | Orthopedic Surgery | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Stephanie L. Illian | Physician Assistant | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Stephanie Rae Fulton | Physician Assistant | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Melissa Beth Randall | Physician Assistant | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Yvonne M Dolohanty-kontny | Physical Therapy | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Anthony R Pasquale | Physical Therapy | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| William M Kohen | Orthopedic Surgery | General Orthopedics PC | 4800 Highland Rd, Waterford, MI 48328-1139 |
| Find all physicians in zip 48328 | |||
| City | WATERFORD |
| Zip Code | 48328 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | WATERFORD + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jaclyn J Brothers.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.