| Marla Rae Smith, | |
|
869 North Illinois Rt 3, Waterloo, IL 62298 | |
| (618) 939-7771 | |
| (618) 939-7746 |
| Full Name | Marla Rae Smith |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 18 Years |
| Location | 869 North Illinois Rt 3, Waterloo, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548444011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LW0102X | Nurse Practitioner - Women's Health | 152008 (Missouri) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | 209007742 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Gateway Regional Medical Center | Granite city, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Heartland Women's Healthcare Ltd | 1759270648 | 31 |
| Entity Name | Heartland Women's Healthcare Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851307532 PECOS PAC ID: 1759270648 Enrollment ID: O20040310001225 |
| Mailing Address | Practice Location Address |
|---|---|
| Marla Rae Smith, 519 Covington Drive, Waterloo, IL 62298-3296 Ph: () - | Marla Rae Smith, 869 North Illinois Rt 3, Waterloo, IL 62298 Ph: (618) 939-7771 |
Mr. Matthew Robert Jones, ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 509 Hamacher St Ste 202, Waterloo, IL 62298 Phone: 618-939-4200 Fax: 618-939-4256 | |
Courtney Mccarty, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 Bradford Ln, Waterloo, IL 62298 Phone: 618-939-0112 Fax: 618-939-0119 | |
Ms. Carol Ann Glascock, APNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 723 Station Xing, Waterloo, IL 62298 Phone: 618-939-1551 Fax: 618-939-1553 | |
Megan Roberts, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 Bradford Ln, Waterloo, IL 62298 Phone: 618-939-0112 | |
Shanna Witges, APRN NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 509 Hamacher St Ste 102, Waterloo, IL 62298 Phone: 618-939-3939 | |
Dr. Megan Lutman, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 921 Kimberly Ln, Waterloo, IL 62298 Phone: 314-456-6008 |