Karly Rose McLeod Hiser, D.N.P., RN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704324281 Issued in MI

Practice address

330 Barclay Ave NE Ste 300
Grand Rapids, MI 49503-2527

Phone

(616) 391-8810

NPI assigned

Feb 17, 2017

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

Other names 1

• Karly Rose McLeod Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1730628199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BARCLAY AVE NE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032527",
            "telephone_number": "616-391-8810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1309 Sheldon Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494172404",
            "country_code": "US",
            "telephone_number": "616-842-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HISER",
        "first_name": "KARLY",
        "middle_name": "ROSE MCLEOD",
        "credential": "D.N.P., RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704324281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLY",
            "last_name": "MCLEOD",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.