Individual provider Active NPI

Drita Nuculovic, LPN

  • Licensed Practical Nurse
  • Flint, MI
National Provider Identifier
1275183535
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703121531 Issued in MI
Practice address
725 Mason St
Flint, MI 48503-2421
Phone
(810) 496-0000
NPI assigned
Sep 18, 2019
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703121531 MI Primary

Addresses

Primary practice location

725 Mason St
Flint, MI 48503-2421

Mailing address

155 N Lake George Rd
Attica, MI 48412-9669
Phone (586) 260-2394

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

State licenses

LicenseStateTypeSpecialty
4703121531MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1275183535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N LAKE GEORGE RD",
            "city": "ATTICA",
            "state": "MI",
            "postal_code": "484129669",
            "telephone_number": "586-260-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 MASON ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032421",
            "telephone_number": "810-496-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCULOVIC",
        "first_name": "DRITA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703121531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.