| Fast Pace Medical Clinic Pllc | |
|
4152 W State Road Hanover IN 47243 | |
| (931) 253-1110 | |
| (931) 722-9919 |
| Full Name | Fast Pace Medical Clinic Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4152 W State Road, Hanover, Indiana |
| Authorized Official Name and Position | Robert Benson (COO) |
| Authorized Official Contact | 9312531110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fast Pace Medical Clinic Pllc Po Box 1258 Waynesboro TN 38485-1258 Ph: (931) 253-1110 | Fast Pace Medical Clinic Pllc 4152 W State Road Hanover IN 47243 Ph: (931) 253-1110 |
| NPI Number | 1649770769 |
|---|---|
| Provider Enumeration Date | 02/15/2018 |
| Last Update Date | 03/11/2024 |
| Medicare PECOS PAC ID | 5395881841 |
|---|---|
| Medicare Enrollment ID | O20200827001491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649770769 | NPI | - | NPPES |
| 300036022 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Julie Ann Maudlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306801642 PECOS PAC ID: 2769386572 Enrollment ID: I20031124000208 |
| Provider Name | Lori D Duggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457352635 PECOS PAC ID: 8921087172 Enrollment ID: I20040720000479 |
| Provider Name | Ardrienne H Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770633034 PECOS PAC ID: 4587630470 Enrollment ID: I20040902000350 |
| Provider Name | Donna Jean Eve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891799730 PECOS PAC ID: 5597735498 Enrollment ID: I20040914001436 |
| Provider Name | Jennifer L Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386649432 PECOS PAC ID: 2264495084 Enrollment ID: I20041111000531 |
| Provider Name | Jennifer Leanne Swank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497736425 PECOS PAC ID: 0840257473 Enrollment ID: I20041215000878 |
| Provider Name | Michael C Harper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487615415 PECOS PAC ID: 7113939133 Enrollment ID: I20060612000145 |
| Provider Name | Michelle Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114087749 PECOS PAC ID: 6901901107 Enrollment ID: I20070417000452 |
| Provider Name | Richard Bobay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881732881 PECOS PAC ID: 6406916238 Enrollment ID: I20081125000071 |
| Provider Name | Theresa D Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992946677 PECOS PAC ID: 9638228737 Enrollment ID: I20090520000310 |
| Provider Name | Tanya Ruth Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407954696 PECOS PAC ID: 6406905223 Enrollment ID: I20090527000078 |
| Provider Name | Ann Marie Vash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154553196 PECOS PAC ID: 8628118809 Enrollment ID: I20091218000409 |
| Provider Name | Lou C Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932424652 PECOS PAC ID: 7517099534 Enrollment ID: I20100709000383 |
| Provider Name | Amy L Bayer-millard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336455641 PECOS PAC ID: 0941494033 Enrollment ID: I20101102001500 |
| Provider Name | Jennifer A Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710284526 PECOS PAC ID: 0547442808 Enrollment ID: I20110308000214 |
| Provider Name | Tara A Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366742488 PECOS PAC ID: 0648455840 Enrollment ID: I20110504000182 |
| Provider Name | Michelle D Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861778763 PECOS PAC ID: 6204000920 Enrollment ID: I20111115000504 |
| Provider Name | Cindy J Pasinski Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427332477 PECOS PAC ID: 1052584950 Enrollment ID: I20120202000191 |
| Provider Name | Valerie J Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629227434 PECOS PAC ID: 6709047798 Enrollment ID: I20120419000044 |
| Provider Name | Barry Louis Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316292956 PECOS PAC ID: 1456256494 Enrollment ID: I20120920000793 |
| Provider Name | Donna M Everman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821343500 PECOS PAC ID: 8729238209 Enrollment ID: I20121017000918 |
| Provider Name | Kristin M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003165275 PECOS PAC ID: 7911151238 Enrollment ID: I20130213000454 |
| Provider Name | Janelle L Meade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962719351 PECOS PAC ID: 1557540549 Enrollment ID: I20130730000913 |
| Provider Name | Vickie Lynn Emberton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730529413 PECOS PAC ID: 4082858741 Enrollment ID: I20130918000782 |
| Provider Name | Frances Laka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023370103 PECOS PAC ID: 9234364712 Enrollment ID: I20131109000337 |
| Provider Name | Deanna Plummer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427483999 PECOS PAC ID: 2567698723 Enrollment ID: I20131115001687 |
| Provider Name | Tina M Woodrome-nethery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962759274 PECOS PAC ID: 4183872021 Enrollment ID: I20140326002168 |
| Provider Name | Melissa A Pyatskowit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154673820 PECOS PAC ID: 5698908010 Enrollment ID: I20140512001383 |
| Provider Name | Holly Laue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255743076 PECOS PAC ID: 0648495549 Enrollment ID: I20140709001985 |
| Provider Name | Laura Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972912376 PECOS PAC ID: 9032338728 Enrollment ID: I20140911000305 |
| Provider Name | Minsun Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205225554 PECOS PAC ID: 2668796137 Enrollment ID: I20150112001154 |
| Provider Name | Jeffrey Coy |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1447494893 PECOS PAC ID: 3274507579 Enrollment ID: I20150626001455 |
| Provider Name | Rebecca E Waugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962888677 PECOS PAC ID: 7113233990 Enrollment ID: I20150825005093 |
| Provider Name | Melissa A Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851794374 PECOS PAC ID: 1153643903 Enrollment ID: I20151013000057 |
| Provider Name | Jill Suzette Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871758904 PECOS PAC ID: 1557439213 Enrollment ID: I20151027000199 |
| Provider Name | Tara L Pearcy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770952897 PECOS PAC ID: 0941500557 Enrollment ID: I20151204000267 |
| Provider Name | Amber L Graber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649649781 PECOS PAC ID: 2668779596 Enrollment ID: I20160321001470 |
| Provider Name | Leann E. Guerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093171829 PECOS PAC ID: 5496044315 Enrollment ID: I20160517000992 |
| Provider Name | Julie Crowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730496563 PECOS PAC ID: 6608038658 Enrollment ID: I20160902001376 |
| Provider Name | Staci D Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417400755 PECOS PAC ID: 6507152808 Enrollment ID: I20160913002077 |
| Provider Name | Priscilla Rasaki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760841548 PECOS PAC ID: 7810296563 Enrollment ID: I20161128001136 |
| Provider Name | Elizabeth A Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053861195 PECOS PAC ID: 5597047209 Enrollment ID: I20170112001938 |
| Provider Name | Laura Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598296873 PECOS PAC ID: 6204111487 Enrollment ID: I20170330002338 |
| Provider Name | Jordan Ryley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184162737 PECOS PAC ID: 8224314661 Enrollment ID: I20170419000747 |
| Provider Name | Lora E Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871032045 PECOS PAC ID: 4284911298 Enrollment ID: I20170501000094 |
| Provider Name | Tonya M Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881128536 PECOS PAC ID: 4587932744 Enrollment ID: I20170613001397 |
| Provider Name | Amber N Handshoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073034500 PECOS PAC ID: 5496025611 Enrollment ID: I20170720003060 |
| Provider Name | Teresa Wuestefeld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902327778 PECOS PAC ID: 8325319114 Enrollment ID: I20170814001109 |
| Provider Name | Charlotte Claire Waling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831610740 PECOS PAC ID: 6901170695 Enrollment ID: I20170919002238 |
| Provider Name | Erin E Diem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588190755 PECOS PAC ID: 1658637590 Enrollment ID: I20171109002756 |
| Provider Name | Jessica N Bekkering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700301090 PECOS PAC ID: 8527325471 Enrollment ID: I20171130001395 |
| Provider Name | Brent Edward Mezger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245744598 PECOS PAC ID: 7810256344 Enrollment ID: I20180109000886 |
| Provider Name | Kasey Hollenbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760864169 PECOS PAC ID: 8325354152 Enrollment ID: I20180222002191 |
| Provider Name | Timothy Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467949073 PECOS PAC ID: 6204190283 Enrollment ID: I20180426002577 |
| Provider Name | Israel Nieto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952890352 PECOS PAC ID: 6800151028 Enrollment ID: I20180517001097 |
| Provider Name | Megan E Mayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003311309 PECOS PAC ID: 3971859141 Enrollment ID: I20180629001405 |
| Provider Name | Cassie Hackman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750886966 PECOS PAC ID: 8820345861 Enrollment ID: I20180720002451 |
| Provider Name | Cody R Stein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346745619 PECOS PAC ID: 2264789866 Enrollment ID: I20180726002518 |
| Provider Name | Amy Allison Sites |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104302744 PECOS PAC ID: 2961750260 Enrollment ID: I20180802002011 |
| Provider Name | Michelle C Mercier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134601552 PECOS PAC ID: 5294086385 Enrollment ID: I20181001000087 |
| Provider Name | Miranda Cassity |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841772472 PECOS PAC ID: 3971855909 Enrollment ID: I20181002003300 |
| Provider Name | Jennifer Erin Scarberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144717927 PECOS PAC ID: 7214289693 Enrollment ID: I20181012000971 |
| Provider Name | Trevor Dylan Whipker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326513268 PECOS PAC ID: 4688928666 Enrollment ID: I20181109000925 |
| Provider Name | Leanne Elizabeth Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720553639 PECOS PAC ID: 1153675665 Enrollment ID: I20181120002162 |
| Provider Name | Bridjett Gassaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194291526 PECOS PAC ID: 8123363652 Enrollment ID: I20190102002177 |
| Provider Name | Rebecca Joy Groen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073070009 PECOS PAC ID: 1254671993 Enrollment ID: I20190318000156 |
| Provider Name | Mary Jacqueline Wharton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992265904 PECOS PAC ID: 8224370465 Enrollment ID: I20190508002091 |
| Provider Name | Danielle R Hollenbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659855310 PECOS PAC ID: 3577805746 Enrollment ID: I20190509000051 |
| Provider Name | Jennifer Lee Tuley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982162723 PECOS PAC ID: 7113166695 Enrollment ID: I20190522003152 |
| Provider Name | Amber Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104480235 PECOS PAC ID: 6305173253 Enrollment ID: I20190815000113 |
| Provider Name | Rebecca Chantelois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992362131 PECOS PAC ID: 1557699618 Enrollment ID: I20190827003313 |
| Provider Name | James B Levenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548726003 PECOS PAC ID: 0143551804 Enrollment ID: I20191010000286 |
| Provider Name | Lachisha Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366914426 PECOS PAC ID: 2769713957 Enrollment ID: I20191021001115 |
| Provider Name | Debra A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245792522 PECOS PAC ID: 8527391416 Enrollment ID: I20191126002372 |
| Provider Name | Tobey Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134770167 PECOS PAC ID: 2769815380 Enrollment ID: I20191211002801 |
| Provider Name | Holly Lyne Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457910689 PECOS PAC ID: 2961835533 Enrollment ID: I20191212001610 |
| Provider Name | Ginger M Richard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093352130 PECOS PAC ID: 8224462460 Enrollment ID: I20191223000603 |
| Provider Name | Dawn K Sirek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760944797 PECOS PAC ID: 6002243110 Enrollment ID: I20200303000838 |
| Provider Name | Emily E Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891326948 PECOS PAC ID: 6204264146 Enrollment ID: I20200307000035 |
| Provider Name | Jessica Lynn Haviland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538792668 PECOS PAC ID: 7719315977 Enrollment ID: I20200322000113 |
| Provider Name | Scott A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255963575 PECOS PAC ID: 1850720244 Enrollment ID: I20200406003203 |
| Provider Name | Lauren M Karbowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083238182 PECOS PAC ID: 0143642934 Enrollment ID: I20200624002154 |
| Provider Name | John Houston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386793008 PECOS PAC ID: 1557441144 Enrollment ID: I20200724002403 |
| Provider Name | Pamela S Cornwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558753152 PECOS PAC ID: 8123444965 Enrollment ID: I20200811003067 |
| Provider Name | Shana L Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992336713 PECOS PAC ID: 0244656528 Enrollment ID: I20200818000108 |
| Provider Name | Cora Elizabeth Maloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467066001 PECOS PAC ID: 5799103487 Enrollment ID: I20200911001974 |
| Provider Name | Melanie Josephine Pickett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902417686 PECOS PAC ID: 5890113195 Enrollment ID: I20200918001337 |
| Provider Name | Hannah Marie King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013520972 PECOS PAC ID: 2163842683 Enrollment ID: I20201021001437 |
| Provider Name | Jessica E Arwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912513896 PECOS PAC ID: 6204246515 Enrollment ID: I20201027002649 |
| Provider Name | Lisa Marie Nagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568083038 PECOS PAC ID: 4284044462 Enrollment ID: I20201028002547 |
| Provider Name | Tami Clinkenbeard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033748736 PECOS PAC ID: 6204247570 Enrollment ID: I20201118001933 |
| Provider Name | Lacey Wills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275135212 PECOS PAC ID: 2769895036 Enrollment ID: I20210105001632 |
| Provider Name | Felicia Marie Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386232429 PECOS PAC ID: 1355755752 Enrollment ID: I20210126002360 |
| Provider Name | Nicole Renee Quainoo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104418904 PECOS PAC ID: 7214343201 Enrollment ID: I20210317002374 |
| Provider Name | Lacey Youhas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669934865 PECOS PAC ID: 2567704943 Enrollment ID: I20210713000550 |
| Provider Name | Amber D Raeth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043988975 PECOS PAC ID: 5193113173 Enrollment ID: I20211025000379 |
| Provider Name | Haley Burgi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235808767 PECOS PAC ID: 7012314255 Enrollment ID: I20211029000992 |
| Provider Name | Camille Mae Carl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730788720 PECOS PAC ID: 3072927649 Enrollment ID: I20211101001132 |
| Provider Name | Jennifer Sue Mendel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225706013 PECOS PAC ID: 0547658908 Enrollment ID: I20211104000639 |
| Provider Name | Lyndia Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972265817 PECOS PAC ID: 9931598125 Enrollment ID: I20211109002259 |
| Provider Name | Desiree Fawn Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962167551 PECOS PAC ID: 3870982028 Enrollment ID: I20211110000943 |
| Provider Name | Ebthal Alasal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497429781 PECOS PAC ID: 7517356173 Enrollment ID: I20211119001929 |
| Provider Name | Sarah Enlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639838824 PECOS PAC ID: 8527459007 Enrollment ID: I20211216000847 |
| Provider Name | Qing Chang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871269829 PECOS PAC ID: 3779975354 Enrollment ID: I20220111000429 |
| Provider Name | Melissa Ritchie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477212231 PECOS PAC ID: 2961895677 Enrollment ID: I20220201002306 |
| Provider Name | Shauna Gish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306940762 PECOS PAC ID: 9537168646 Enrollment ID: I20220302002114 |
| Provider Name | Pamela Jane Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912661968 PECOS PAC ID: 9638564917 Enrollment ID: I20220323002340 |
| Provider Name | Abby N Strong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891442042 PECOS PAC ID: 4486040235 Enrollment ID: I20220405001125 |
| Provider Name | Jennifer Coffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063065209 PECOS PAC ID: 7810228335 Enrollment ID: I20220426001316 |
| Provider Name | Haleigh Jordan Nidlinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356011266 PECOS PAC ID: 6709263882 Enrollment ID: I20220510002610 |
| Provider Name | Kristain Nicole Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801541719 PECOS PAC ID: 7214315720 Enrollment ID: I20220610002095 |
| Provider Name | Kellee Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154073963 PECOS PAC ID: 1850770249 Enrollment ID: I20220615000346 |
| Provider Name | Danielle Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609434539 PECOS PAC ID: 8527492636 Enrollment ID: I20220701001622 |
| Provider Name | Teresa Kinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609178987 PECOS PAC ID: 6305035783 Enrollment ID: I20220711002488 |
| Provider Name | Melissa Wilkerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144854456 PECOS PAC ID: 8224417837 Enrollment ID: I20220907003294 |
| Provider Name | Sarah Rudkosky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457079758 PECOS PAC ID: 1355725474 Enrollment ID: I20220908001157 |
| Provider Name | Emily R Strube |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699405589 PECOS PAC ID: 4385029420 Enrollment ID: I20220909002803 |
| Provider Name | Nathan Reed Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326777152 PECOS PAC ID: 7214312735 Enrollment ID: I20220920002777 |
| Provider Name | Emily Waldron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407587611 PECOS PAC ID: 7315322724 Enrollment ID: I20220921003282 |
| Provider Name | Katherine Jean Wadsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508588708 PECOS PAC ID: 1456736701 Enrollment ID: I20220922001359 |
| Provider Name | Carrie Ann Deakins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013635333 PECOS PAC ID: 0941686018 Enrollment ID: I20220928000545 |
| Provider Name | Austin Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255840492 PECOS PAC ID: 5092131631 Enrollment ID: I20221005002161 |
| Provider Name | Lisa Ruth May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548984248 PECOS PAC ID: 3072989201 Enrollment ID: I20221013000725 |
| Provider Name | Melissa Sue Parnin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134730427 PECOS PAC ID: 0345638805 Enrollment ID: I20221122000508 |
| Provider Name | Caitlyn Mariel Smallwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083384218 PECOS PAC ID: 4486022019 Enrollment ID: I20221201001978 |
| Provider Name | Lauren Nicole Shewman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184334922 PECOS PAC ID: 9830568005 Enrollment ID: I20221209001343 |
| Provider Name | Colby Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295406551 PECOS PAC ID: 3375912314 Enrollment ID: I20221213002717 |
| Provider Name | Karlee Stamey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164976593 PECOS PAC ID: 9335436435 Enrollment ID: I20221216001519 |
| Provider Name | Jennifer Thomason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255099263 PECOS PAC ID: 7214314079 Enrollment ID: I20221222001564 |
| Provider Name | Renee Marie Goodrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124750815 PECOS PAC ID: 6901276104 Enrollment ID: I20230104002705 |
| Provider Name | Chad Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649981580 PECOS PAC ID: 2769852599 Enrollment ID: I20230112000152 |
| Provider Name | Julie Elizabeth Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295449437 PECOS PAC ID: 8325419039 Enrollment ID: I20230117001167 |
| Provider Name | Haley L Mifflin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639885791 PECOS PAC ID: 6608247713 Enrollment ID: I20230128000331 |
| Provider Name | Leslie Susan Secrist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740945740 PECOS PAC ID: 4082005020 Enrollment ID: I20230203000727 |
| Provider Name | Fidelity Ageh Akonji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598462939 PECOS PAC ID: 8820460942 Enrollment ID: I20230217001170 |
| Provider Name | Irene M Nzuki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285340455 PECOS PAC ID: 4981077047 Enrollment ID: I20230310001706 |
| Provider Name | Andrea Marie Maley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205546959 PECOS PAC ID: 9537533450 Enrollment ID: I20230316000435 |
| Provider Name | Misty Dawn Bozarth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598467896 PECOS PAC ID: 7517331788 Enrollment ID: I20230330001032 |
| Provider Name | Hayley Bussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285324962 PECOS PAC ID: 0941666358 Enrollment ID: I20230509002564 |
| Provider Name | Takeyah A Rosenthall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275218083 PECOS PAC ID: 8123486123 Enrollment ID: I20230623001065 |
| Provider Name | Kayla Richter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679259030 PECOS PAC ID: 7113386723 Enrollment ID: I20230629002570 |
| Provider Name | Trisha Ann Darling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700548369 PECOS PAC ID: 8123483450 Enrollment ID: I20230721002075 |
| Provider Name | Tara Engel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780363572 PECOS PAC ID: 5698136539 Enrollment ID: I20230725003282 |
| Provider Name | Jodi Guy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104411875 PECOS PAC ID: 7214345289 Enrollment ID: I20230804002241 |
| Provider Name | Sheena Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497449961 PECOS PAC ID: 6709240492 Enrollment ID: I20230913004121 |
| Provider Name | Julie Coulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386893147 PECOS PAC ID: 8527124940 Enrollment ID: I20230915002359 |
| Provider Name | Kara Jean Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013794130 PECOS PAC ID: 7012361306 Enrollment ID: I20230920001439 |
| Provider Name | Jayma Marie Bauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619613825 PECOS PAC ID: 6507212396 Enrollment ID: I20231031001467 |
| Provider Name | Dana Pinkerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871375980 PECOS PAC ID: 6507214293 Enrollment ID: I20231117002094 |
| Provider Name | Kelly Schoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134996390 PECOS PAC ID: 3779932785 Enrollment ID: I20231214003680 |
| Provider Name | Lauren Kay Carlisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184811069 PECOS PAC ID: 9638528664 Enrollment ID: I20231215000300 |
| Provider Name | Ashley Michelle Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265207682 PECOS PAC ID: 6800245754 Enrollment ID: I20231218001871 |
| Provider Name | Aliyah Williams-boynton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477320638 PECOS PAC ID: 7315397866 Enrollment ID: I20231222002800 |
| Provider Name | Cameron Kitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114601267 PECOS PAC ID: 2961852132 Enrollment ID: I20231229002421 |
| Provider Name | Heather Myree Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962279216 PECOS PAC ID: 2668824806 Enrollment ID: I20240123003742 |
| Provider Name | Kristin Nicole Steed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063273324 PECOS PAC ID: 2567815418 Enrollment ID: I20240127000559 |
| Provider Name | Haley Holscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932961893 PECOS PAC ID: 3173966223 Enrollment ID: I20240206003322 |
| Provider Name | Shelly L Bunch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992581557 PECOS PAC ID: 3274976295 Enrollment ID: I20240207000753 |
| Provider Name | Elizabeth Anne Mysliwiec |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013640200 PECOS PAC ID: 0749624724 Enrollment ID: I20240217000351 |
| Provider Name | Angela M Hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255101333 PECOS PAC ID: 3173969086 Enrollment ID: I20240314001307 |
| Provider Name | Sultana Saber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710752175 PECOS PAC ID: 2860839958 Enrollment ID: I20240325003351 |
| Provider Name | Nikiesha Rollins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487404190 PECOS PAC ID: 9739527029 Enrollment ID: I20240405000540 |
| Provider Name | Shelby Rae Lafon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346000486 PECOS PAC ID: 4981042140 Enrollment ID: I20240405003704 |
| Provider Name | James Pennington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063098192 PECOS PAC ID: 4688017486 Enrollment ID: I20240423001413 |
| Provider Name | Lindsey Marie Garber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417700402 PECOS PAC ID: 5395185201 Enrollment ID: I20240425002110 |
| Provider Name | Traci Van Gorden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679513451 PECOS PAC ID: 2163434481 Enrollment ID: I20240620000504 |
| Provider Name | Danielle Marie Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073356473 PECOS PAC ID: 9032653423 Enrollment ID: I20240626002676 |
| Provider Name | Malvie Scarlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295517951 PECOS PAC ID: 4981149481 Enrollment ID: I20240709001981 |
| Provider Name | Brandi Batten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467007716 PECOS PAC ID: 5092164301 Enrollment ID: I20240716000850 |
| Provider Name | Christina Nunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508604984 PECOS PAC ID: 8224575501 Enrollment ID: I20240805001238 |
| Provider Name | Melinda Marie Cornelius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184345829 PECOS PAC ID: 5698113652 Enrollment ID: I20240806001066 |
| Provider Name | Marcie Rae Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770327413 PECOS PAC ID: 1456899152 Enrollment ID: I20240813001666 |
| Provider Name | Breanna Tyler Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861224099 PECOS PAC ID: 7618416454 Enrollment ID: I20240826001121 |
| Provider Name | Ashley Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902324338 PECOS PAC ID: 2163766593 Enrollment ID: I20240830000630 |
| Provider Name | Deanna Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548093289 PECOS PAC ID: 7810437845 Enrollment ID: I20240905001648 |
| Provider Name | Krystal Osinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710587944 PECOS PAC ID: 5395151013 Enrollment ID: I20240920000807 |
| Provider Name | Audrey R Turchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700612686 PECOS PAC ID: 3870034234 Enrollment ID: I20240925002505 |
| Provider Name | Savannah R Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386014918 PECOS PAC ID: 7517277023 Enrollment ID: I20240930003153 |
| Provider Name | Sarah Margaret Sexson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598583858 PECOS PAC ID: 9537691845 Enrollment ID: I20241011000502 |
| Provider Name | Malisha Dawn Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811725500 PECOS PAC ID: 4789116211 Enrollment ID: I20241022001834 |
| Provider Name | Autumn Kay Sexton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720769896 PECOS PAC ID: 1254864689 Enrollment ID: I20241024000198 |
| Provider Name | Robert Glenn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902033210 PECOS PAC ID: 9335328467 Enrollment ID: I20241108001118 |
| Provider Name | Jessica Carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467022574 PECOS PAC ID: 4587067780 Enrollment ID: I20241114000328 |
| Provider Name | Jessica Burress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265115950 PECOS PAC ID: 7315391075 Enrollment ID: I20241217000350 |
| Provider Name | Kelley Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730502733 PECOS PAC ID: 6709174584 Enrollment ID: I20250224001018 |
| Provider Name | Janet S Hannah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861635799 PECOS PAC ID: 1759439466 Enrollment ID: I20250402001698 |
| Provider Name | Rhomonda Scifres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053137455 PECOS PAC ID: 4587181573 Enrollment ID: I20250502001835 |