Individual provider Active NPI

Mary Ginette Mikulich, RN, BSN

  • Psychiatric/Mental Health Registered Nurse
  • Saginaw, MI
National Provider Identifier
1154918647
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
4704201347 Issued in MI
Practice address
3353 Hospital Rd
Saginaw, MI 48603-9622
Phone
(989) 746-9633
Fax
(989) 790-1488
NPI assigned
Dec 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704201347 MI Primary

Addresses

Primary practice location

3353 Hospital Rd
Saginaw, MI 48603-9622

Mailing address

3353 Hospital Rd
Saginaw, MI 48603-9622
Phone (989) 746-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704201347MIMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1154918647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 HOSPITAL RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486039622",
            "telephone_number": "989-746-9633",
            "fax_number": "989-790-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 HOSPITAL RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486039622",
            "telephone_number": "989-746-9633",
            "fax_number": "989-790-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULICH",
        "first_name": "MARY",
        "middle_name": "GINETTE",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704201347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.