Jillian Marie Misekow

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

4704307091 Issued in MI

Practice address

3457 E Lake Rd
Clio, MI 48420-7932

Phone

(989) 413-0542

NPI assigned

Nov 20, 2019

Last updated

Nov 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1487290938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 E LAKE RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484207932",
            "telephone_number": "989-413-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 E LAKE RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484207932",
            "telephone_number": "989-413-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISEKOW",
        "first_name": "JILLIAN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MI",
            "license": "4704307091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Registered Nurse in Clio, MI
• Providers in Clio, MI by specialty
• Emergency Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.