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Deactivated NPI 1366970428 Deactivated / Inactive NPI Male Practitioner

Dave Wayne Boissineau , LPN

Licensed Practical Nurse • Ishpeming, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dave Boissineau has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 01, 2017
NPI Deactivation Date June 26, 2019
Total Practice Duration ~2 Years of Practice (2017 – 2019)

Professional Overview & Biography Verified Profile Summary

Dave Boissineau, LPN was a registered Licensed Practical Nurse practicing in Ishpeming, MI. Throughout an active medical career spanning 2 years, Dave Boissineau provided care at the practice location at 97 S 4TH ST until profile deactivation on 2019-06-26.

Practice Location & Contact Primary Location

Practice Address

97 S 4th St

Ishpeming, MI 498492168

Telephone 9064852347
Associated Practice Facility / Clinic
🏢 Great Lakes Recovery Centers Facility NPI 1760626311

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Ishpeming, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Ishpeming, MI (4550 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License MI 4703117117

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Aleshia Kaszba-Pio

Case Manager/Care Coordinator

NPI 1043192867
Maya Jordan

Registered Nurse

NPI 1063210276
Carla Van Roy

Social Worker - Clinical

NPI 1104545706
Dr. Helen Kahn , PhD

Psychologist - Adult Development & Aging

NPI 1194054320

Doctor of Philosophy (Ph.D.)

NPI 1194156687

Doctor of Philosophy (Ph.D.), Licensed Master Social Worker

Nina Purtee

Case Manager/Care Coordinator

NPI 1245978436

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 26, 2019

Record deactivated on June 26, 2019

NPI Profile Active June 01, 2017

NPI status registered as active in NPPES database

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Updated Practice Location June 01, 2017

Registered at 97 S 4TH ST, ISHPEMING, MI 498492168 (Tel: 9064852347)

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Updated Business Mailing Address June 01, 2017

Registered at 97 S 4TH ST, ISHPEMING, MI 498492168 (Tel: 9064852347)

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Provider Name / Credentials Updated June 01, 2017

Recorded as DAVE BOISSINEAU, LPN

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2017

Licensed Practical Nurse (License #4703117117 in MI)

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Initial NPI Registration & Enumeration June 01, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366970428
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 01, 2017
Last Update: June 01, 2017
Deactivation Date: June 26, 2019

Mailing Address

97 S 4th St

Ishpeming, MI 498492168

Phone: 9064852347

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.