Individual provider Active NPI

Jennifer Marie Gushen, RN

  • Registered Nurse
  • Saint Louis, MI
National Provider Identifier
1215447313
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704267788 Issued in MI
Practice address
606 Teman St
Saint Louis, MI 48880-1617
Phone
(989) 395-2402
NPI assigned
Oct 4, 2017
Last updated
Oct 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704267788 MI Primary

Addresses

Primary practice location

606 Teman St
Saint Louis, MI 48880-1617

Mailing address

606 Teman St
Saint Louis, MI 48880-1617
Phone (989) 395-2402

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704267788MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1215447313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 TEMAN ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801617",
            "telephone_number": "989-395-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 TEMAN ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801617",
            "telephone_number": "989-395-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSHEN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704267788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.