Individual provider Active NPI

Mirna Dusek

  • Licensed Practical Nurse
  • Allegan, MI
National Provider Identifier
1457220394
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703121085 Issued in MI
Practice address
3511 Lake Allegan Dr
Allegan, MI 49010-8402
Phone
(956) 518-0639
NPI assigned
Oct 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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 4703121085 MI Primary

Addresses

Primary practice location

3511 Lake Allegan Dr
Allegan, MI 49010-8402

Mailing address

3511 Lake Allegan Dr
Allegan, MI 49010-8402

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
4703121085MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1457220394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 LAKE ALLEGAN DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490108402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 LAKE ALLEGAN DR",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490108402",
            "telephone_number": "956-518-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSEK",
        "first_name": "MIRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703121085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.