| Elissa Jo Davenport, NP | |
|
8941 N Rodgers Ct Se, Caledonia, MI 49316-8013 | |
| (616) 252-5300 | |
| (616) 252-5390 |
| Full Name | Elissa Jo Davenport |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 8941 N Rodgers Ct Se, Caledonia, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962824375 | NPI | - | NPPES |
| 4704260086 | Other | MI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 4704260086 (Michigan) | Primary |
| Entity Name | Metropolitan Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811937519 PECOS PAC ID: 5597651836 Enrollment ID: O20040507000012 |
| Mailing Address | Practice Location Address |
|---|---|
| Elissa Jo Davenport, NP 5900 Byron Center Ave Sw, Medical Administration, Wyoming, MI 49519-9606 Ph: (616) 252-3243 | Elissa Jo Davenport, NP 8941 N Rodgers Ct Se, Caledonia, MI 49316-8013 Ph: (616) 252-5300 |
Julie Stinton, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8941 N Rodgers Ct Se, Caledonia, MI 49316 Phone: 616-252-5300 Fax: 616-252-5390 | |
Terri Rosel, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8941 N Rodgers Ct Se, Caledonia, MI 49316 Phone: 616-252-5300 Fax: 616-252-5390 | |
Musu Olu Sonnie-williams, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6897 Dale Hollow Dr Se, Caledonia, MI 49316 Phone: 616-648-3246 | |
Racheal Brooker, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9090 S Rodgers Ct Se, Caledonia, MI 49316 Phone: 616-891-0422 | |
Nichole Anne Bundschuh, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9090 S Rodgers Ct Se Ste A, Caledonia, MI 49316 Phone: 616-891-0422 | |
Binita Baniya, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7340 Royal Ridge Dr Se, Caledonia, MI 49316 Phone: 616-426-0202 | |
Jessica Lynn Zwolinski, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1661 Crystal Springs Blvd Se, Caledonia, MI 49316 Phone: 616-326-0114 Fax: 616-369-3790 |