Sandra Tietemia, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703085335 Issued in MI

Practice address

955 W Broadway Ave
Muskegon, MI 49441-3521

Phone

(231) 755-0637

Fax

(231) 755-6208

NPI assigned

Jul 22, 2013

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Shore Medical

  • Home Health Agency
  • Muskegon, MI
  • NPI 1316378839
  NPD (past)

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1649612482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 MONOLITH DR",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494267652",
            "telephone_number": "231-755-0637",
            "fax_number": "231-755-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413521",
            "telephone_number": "231-755-0637",
            "fax_number": "231-755-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIETEMIA",
        "first_name": "SANDRA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703085335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonnie Thomson, NP
• Noah Patrick Thormeier, D.O.
• Karen A Thornburg, MD
• Joshua Ryan Thurman, PA-C
• Lisa Diane Thurman, PA-C
• Carolyn Tiffany
• Michael Graham Tiley, LMT
• Trinity E Tindall
• Robert J Tironi, DDS
• Kezia Auralya Tjahjanto

• Licensed Practical Nurse in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.