MS. SHAMBRA CULLUM (NPI# 1033615463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033615463 |
| Entity Type | Individual |
| Full Name | MS. SHAMBRA CULLUM |
| Credential | APN |
| Practice Address |
1 Saint Elizabeth Blvd O Fallon IL 62269-1099 |
| Practice Telephone | 2179941485 |
| Mailing Telephone | 2179941485 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209016520 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 SAINT ELIZABETH BLVD |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-1099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629057302 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | General Acute Care Hospital | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2006-01-11 |
| 1568084903 | Amanda Sue Burgesen | Registered Nurse | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2020-05-07 |
| 1235764218 | Courtney J Harris | Nurse Anesthetist, Certified Registered | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2020-03-10 |
| 1811532666 | Cindy Lynette Sanden | Nurse Practitioner | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-11-14 |
| 1558906750 | Nicole Dawn Brueggemann | Physician Assistant | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-11-12 |
| 1912548587 | Adela Redzic | Physician Assistant | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-10-03 |
| 1578128732 | Carly Rambo | Registered Nurse | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-05-03 |
| 1033670187 | Bart S Bowers | Registered Nurse | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-03-29 |
| 1205300795 | Kris Kahler | Radiology | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-01-17 |
| 1346749090 | Gcxp Inc | Emergency Medicine | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2018-02-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353308 | Danielle Renae Blake | Nurse Practitioner | 808 E 2nd St, O Fallon, IL 62269-2217 | 2020-07-07 |
| 1588293864 | Nicole Pashia | Nurse Practitioner | 983 Crestwood Ln, O Fallon, MO 63366-1676 | 2020-04-07 |
| 1104394899 | Christina Marie Ivy | Nurse Practitioner | 2765 Red Cedar Parc Dr S, O Fallon, MO 63368-6609 | 2018-11-12 |
| 1225514722 | Rachel Dulaney | Nurse Practitioner | 1405 N Green Mount Rd Ste 240, O Fallon, IL 62269-3494 | 2018-07-17 |
| 1053822551 | Leah W Wangui | Nurse Practitioner | 225 Mystic Cv, O Fallon, MO 63368-9654 | 2017-10-24 |
| 1932655479 | Danielle Besand | Nurse Practitioner | 18 S Boxwood Ln, O Fallon, MO 63366-1626 | 2016-08-25 |
| 1649626144 | Donna Jewell | Nurse Practitioner | 331 Logan Dr, O Fallon, IL 62269-7146 | 2016-05-13 |
| 1679939516 | Gladys Schmees | Nurse Practitioner | 408 Wolfpass Dr, O Fallon, IL 62269-6972 | 2016-01-07 |
| 1275916934 | Blue Valley Surgical Associates, LLC | Nurse Practitioner | 2341 Highway K, Suite 214, O Fallon, MO 63368-8604 | 2015-06-30 |
| 1861894925 | Elizabeth Morton | Nurse Practitioner | 223 Shady Rock Ln, O Fallon, MO 63368-7471 | 2014-09-20 |
| Find all providers in O FALLON | ||||
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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.