Active NPI
Kylee Stager, RN
- Registered Nurse
- Marysville, MI
National Provider Identifier
1508594599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704243096
- Practice address
- 3350 Gratiot Blvd
Marysville, MI 48040-2121 - Phone
- (810) 364-4000
- NPI assigned
- Aug 9, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704243096 | MI | Primary |
Addresses
Primary practice location
3350 Gratiot Blvd
Marysville, MI 48040-2121
Mailing address
3050 Commerce Dr Ste C
Fort Gratiot, MI 48059-3819
Phone (810) 385-4441
Other practice location 1
36267 26 Mile Rd Ste 3
Lenox, MI 48048-3253
Phone (586) 716-1371
Other practice location 2
2425 Military St Bldg 2
Port Huron, MI 48060-6692
Phone (810) 984-5700
Other practice location 3
3050 Commerce Dr Ste C
Fort Gratiot, MI 48059-3819
Phone (810) 385-4441 ext. 1155
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4704243096 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660003200000",
"number": "1508594599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 COMMERCE DR STE C",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "480593819",
"telephone_number": "810-385-4441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3350 GRATIOT BLVD",
"city": "MARYSVILLE",
"state": "MI",
"postal_code": "480402121",
"telephone_number": "810-364-4000"
}
],
"practiceLocations": [
{
"address_1": "36267 26 Mile Rd Ste 3",
"address_purpose": "LOCATION",
"city": "Lenox",
"state": "MI",
"postal_code": "480483253",
"country_code": "US",
"telephone_number": "586-716-1371",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2425 Military St Bldg 2",
"address_purpose": "LOCATION",
"city": "Port Huron",
"state": "MI",
"postal_code": "480606692",
"country_code": "US",
"telephone_number": "810-984-5700",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3050 Commerce Dr Ste C",
"address_purpose": "LOCATION",
"city": "Fort Gratiot",
"state": "MI",
"postal_code": "480593819",
"country_code": "US",
"telephone_number": "810-385-4441 x1155",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STAGER",
"first_name": "KYLEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-09",
"last_updated": "2022-08-09",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704243096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.