MIMI SONG IDICULA (NPI# 1003009580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003009580 |
| Entity Type | Individual |
| Full Name | MIMI SONG IDICULA |
| Credential | NP |
| Practice Address |
1717 W University Dr #408 Mckinney TX 75069 |
| Mailing Address |
6161 N State Highway 161 Irving TX 75038-2220 |
| Practice Telephone | 9725482600 |
| Practice Fax Number | 9725482610 |
| Mailing Telephone | 9722587499 |
| Mailing Fax Number | 9722570897 |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2018-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 10049 | TX | Chiropractic Providers |
| Y | 363L00000X | Nurse Practitioner | AP137449 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NURSE PRACTITIONER | AP137449 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1717 W University Dr, #408, Mckinney, TX 750693218 | 9725482600 | 9725482610 |
| Street Address |
1717 W UNIVERSITY DR #408 |
| City | MCKINNEY |
| State | TX |
| Zip Code | 75069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821042805 | Mckinney Open Mri LLC | Clinic/Center | 1717 W University Dr, Suite 405, Mckinney, TX 75069-3218 | 2006-05-22 |
| 1205180650 | Preferred Imaging of Mckinney, LLC | Clinical Medical Laboratory | 1717 W University Dr, Suite 450, Mckinney, TX 75069-3218 | 2012-11-07 |
| 1699044115 | Quickcare Clinic of Mckinney | Clinic/Center | 1717 W University Dr, Ste 412, Mckinney, TX 75069-3218 | 2011-12-29 |
| 1851541700 | Cynergy Chiropractic Center Pa | Chiropractor | 1717 W University Dr, Suite 408, Mckinney, TX 75069-3218 | 2008-09-29 |
| 1568504116 | Santa Fe Clinic | Internal Medicine | 1717 W University Dr, # 412, Mckinney, TX 75069-3218 | 2007-02-12 |
| 1457397655 | Jason Steven Hill | Chiropractor | 1717 W University Dr, Suite 408, Mckinney, TX 75069-3218 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026029 | Tiffany Lynn Lowery | Family Medicine | 103 East Lamar St, Mckinney, TX 75069 | 2020-09-06 |
| 1689285603 | Heather Nicole Hester | Social Worker | 4601 Medical Drive Ste F, Mckinney, TX 75069 | 2020-08-13 |
| 1114552916 | Wonderfully Made Wellness Sanctuary | Nurse Practitioner | 105 S. Tennessee Street Suite 102, Mckinney, TX 75069 | 2020-03-12 |
| 1477030385 | Kristyn Lowe | Licensed Vocational Nurse | 110 E Louisiana, Suite 201-amp, Mckinney, TX 75069 | 2018-07-24 |
| 1710464631 | Shasta Massey | Registered Nurse | 110 E Louisinana, Suite 201-amp, Mckinney, TX 75069 | 2018-07-24 |
| 1215414149 | Allison Marion | Registered Nurse | 110 E Louisiana St, Suite 201-amp, Mckinney, TX 75069 | 2018-07-24 |
| 1497273759 | Kim C. Carson | Counselor | 201 W. Virginia Suite 203, Mckinney, TX 75069 | 2017-09-06 |
| 1629596283 | Christy Lynne Billings | Counselor | 101 W. Louisiana St. Suite # 208, Mckinney, TX 75069 | 2017-09-05 |
| 1932623626 | Lauren Broadbent | Speech-Language Pathologist | 265 Plateau Drive, Mckinney, TX 75069 | 2017-08-03 |
| 1932623147 | Lindsey Ann Gillespie | Nurse Practitioner | 4561 Medical Center Drive, Mckinney, TX 75069 | 2017-07-29 |
| Find all providers in zip 75069 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578049565 | Vilasben K Bhut | Nurse Practitioner | 609 Boyd Creek Rd, Mckinney, TX 75071-3325 | 2018-07-13 |
| 1780192203 | Oyetokunbo Lemoru | Nurse Practitioner | 2730 Virginia Pkwy Ste 200, Mckinney, TX 75071-5028 | 2018-01-18 |
| 1104330737 | Georgette Ebuh | Nurse Practitioner | 8000 Eldorado Pkwy Ste A, Mckinney, TX 75070 | 2017-11-17 |
| 1376061820 | Komal Pravin-patel | Nurse Practitioner | 4510 Medical Center Dr Ste 204, Mckinney, TX 75069-1605 | 2017-09-05 |
| 1417390188 | Bdpm Mckinney, Pllc | Nurse Practitioner | 270 Redbud Blvd Ste 100, Mckinney, TX 75069-3390 | 2013-04-12 |
| 1649260605 | Qingwen Elaine Lin | Nurse Practitioner | 5309 W University Dr, Mckinney, TX 75071-7824 | 2005-10-21 |
| 1790319242 | Brittany Huckaby | Nurse Practitioner | 4510 Medical Center Dr Ste 208, Mckinney, TX 75069-1602 | 2020-02-24 |
| 1356983845 | All About Healing Mobile Wound Care Plus, LLC | Nurse Practitioner | 2150 S Central Expy Ste 200, Mckinney, TX 75070-4000 | 2019-10-16 |
| 1730684531 | Empower Weight Loss Associates | Nurse Practitioner | 4510 Medical Center Dr Ste 314, Mckinney, TX 75069-6851 | 2018-03-26 |
| 1245739564 | Megan Morton Mckenzie | Nurse Practitioner | 5291 W University Dr, Mckinney, TX 75071 | 2018-02-02 |
| Find all providers in MCKINNEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.