MS. MANEESHA T JOSEPH (NPI# 1033494455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033494455 |
| Entity Type | Individual |
| Full Name | MS. MANEESHA T JOSEPH |
| Other Name | MANEESHA T POULOSE |
| Credential | FNP |
| Practice Address |
1302 Franklin Ave Suite 3400 Normal IL 61761-3551 |
| Practice Telephone | 3095568300 |
| Practice Fax Number | 3095568295 |
| Mailing Telephone | 3095568300 |
| Mailing Fax Number | 3095568295 |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2015-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
RN 9300306 | FL | Nursing Service Providers |
| N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
582593-1 | NY | Nursing Service Providers |
| N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
041.394485 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.008939 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
F336606-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1302 FRANKLIN AVE SUITE 3400 |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-3551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419679 | John D Fulk | Physician Assistant | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2005-06-29 |
| 1235686759 | Brooke Davis | Nurse Practitioner | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2016-09-01 |
| 1043676109 | Amy J Stites | Physician Assistant | 1302 Franklin Ave, Suite 4800, Normal, IL 61761-3551 | 2016-01-05 |
| 1255700316 | Abigail G Cervantes | Obstetrics & Gynecology | 1302 Franklin Ave, Suite 2800, Normal, IL 61761-6526 | 2015-09-18 |
| 1700252228 | Prairieland Outpatient Diagnostic Center, LLC | Anesthesiology | 1302 Franklin Ave, Suite 1000, Normal, IL 61761-3551 | 2015-08-19 |
| 1467860445 | Christie Rocke | Nurse Practitioner | 1302 Franklin Ave, Suite 3400, Normal, IL 61761-3551 | 2014-07-23 |
| 1114343225 | Jennifer Lanz | Nurse Practitioner | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2014-03-13 |
| 1396189411 | Consulting Anesthesiologists LLC | Anesthesiology | 1302 Franklin Ave, Normal, IL 61761-3551 | 2013-04-19 |
| 1285903799 | Bromenn Physicians Management Corporation | Counselor | 1302 Franklin Ave, Suite 1100, Normal, IL 61761-3551 | 2011-12-29 |
| 1922377431 | Bromenn Physicians Management Corporation | Internal Medicine | 1302 Franklin Ave, Suite 4500, Normal, IL 61761-3551 | 2011-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161865 | Abigail Hardesty | Nurse Practitioner | 201 Illinois State Univ, Normal, IL 61790-0001 | 2020-10-09 |
| 1245846989 | Susan M Carl | Nurse Practitioner | 201 North University Street, Normal, IL 61790-0001 | 2020-09-18 |
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1821645607 | Ma Benirose Mcnaught | Nurse Practitioner | 1324 Berkley Rd, Normal, IL 61761-9550 | 2019-08-26 |
| 1427538198 | Taylor Ashton Taylor | Nurse Practitioner | 1302 Franklin Ave Ste 2200, Normal, IL 61761-6500 | 2018-08-21 |
| 1972018398 | Heather Winquist | Nurse Practitioner | 1300 Franklin Ave Ste 230c, Normal, IL 61761-3709 | 2017-12-07 |
| 1619331311 | Rachael Hudgins | Nurse Practitioner | 201n University, Campus Box 2540, Normal, IL 61790-0001 | 2016-04-08 |
| 1568866598 | Molly Grant | Nurse Practitioner | 201 N University St, Normal, IL 61790-2540 | 2014-10-20 |
| 1841488855 | David L Kieser | Nurse Practitioner | 1304 Franklin Ave., Normal, IL 61761 | 2007-10-04 |
| 1750321667 | Geneva A. Petersen | Nurse Practitioner | 1302 Franklin Ave Ste 2800, Normal, IL 61761-6526 | 2006-06-08 |
| Find all providers in NORMAL | ||||
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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.