NANCY K KERTZ (NPI# 1063424836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063424836 |
Entity Type | Individual |
Full Name | NANCY K KERTZ |
Credential | NP |
Practice Address |
4117 S Water Tower Pl Suite D Mount Vernon IL 62864-6293 |
Mailing Address |
107 Lincoln Ln Brookings SD 57006-2634 |
Practice Telephone | 6182424848 |
Practice Fax Number | 6182424198 |
Mailing Telephone | 6056955565 |
Enumeration Date | 2006-08-12 |
Last Update Date | 2007-10-22 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP000435 | SD | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
4117 S WATER TOWER PL SUITE D |
City | MOUNT VERNON |
State | IL |
Zip Code | 62864-6293 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720057730 | Heartland Occupational Medicine Physicians of Illinois S C | Family Medicine | 4117 S Water Tower Pl, Suite D, Mount Vernon, IL 62864-6293 | 2006-03-14 |
1679979157 | Michael Murray | Physician Assistant | 4117 S Water Tower Pl, Suite D, Mount Vernon, IL 62864-6567 | 2014-11-12 |
1134470859 | King City Physician Company, LLC | Family Medicine | 4117 S Water Tower Pl, Suite C, Mount Vernon, IL 62864-6567 | 2012-09-20 |
1821158833 | David J. Lane, Ltd. | Audiologist | 4117 S Water Tower Pl, Suite C, Mount Vernon, IL 62864-6293 | 2006-12-11 |
1285650838 | Jacques Papazian M.d,s.c. | Otolaryngology | 4117 S Water Tower Pl, Suite C, Mount Vernon, IL 62864-6293 | 2006-07-15 |
1164472155 | David J Lane | Audiologist | 4117 S Water Tower Pl, Suite C, Mount Vernon, IL 62864-6293 | 2006-05-11 |
1366491193 | Jacques Papazian | Family Medicine | 4117 S Water Tower Pl, Suite C, Mount Vernon, IL 62864-6293 | 2006-05-09 |
1053380683 | Charles W Neal | Family Medicine | 4117 S Water Tower Pl, Suite D, Mount Vernon, IL 62864-6293 | 2006-03-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
Find all providers in zip 62864 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003421066 | Amantha Theodore | Nurse Practitioner | 531 E Lincoln Ave Apt 4n, Mount Vernon, NY 10552-3743 | 2020-09-15 |
1093320392 | Ryan Michael Winder | Nurse Practitioner | 615 A Ave Se, Mount Vernon, IA 52314-1532 | 2020-09-14 |
1154969103 | Sarah Jacqueline Lim-dwyer | Nurse Practitioner | 1400 East Kincaid Street, Mount Vernon, WA 98274-4127 | 2019-12-19 |
1306481056 | Julie Marie Forbes-laborde | Nurse Practitioner | 27 Beekman Ave Apt 2, Mount Vernon, NY 10553-1491 | 2019-11-15 |
1447819305 | Gladys E Aideyan | Nurse Practitioner | 130 Stuyvesant Plz, Mount Vernon, NY 10552-1413 | 2019-06-13 |
1417467929 | Shernette T Suer | Nurse Practitioner | 105 Stevens Ave Ste 506, Mount Vernon, NY 10550-2683 | 2017-10-10 |
1194254946 | Amy Haibel | Nurse Practitioner | 206 S Mulberry St Ste B, Mount Vernon, OH 43050-3331 | 2017-06-06 |
1699216697 | Diana Mcnear | Nurse Practitioner | 421 S 3rd Ave, Mount Vernon, NY 10550-4507 | 2017-03-10 |
1598200867 | Vivienne Iona Bartley | Nurse Practitioner | 115 Primrose Avenue, Mount Vernon, NY 10552 | 2016-12-22 |
1144772955 | Tahiesha Tolbert | Nurse Practitioner | 153 Stevens Ave Ste 4, Mount Vernon, NY 10550-2543 | 2016-10-27 |
Find all providers in MOUNT VERNON |
City | MOUNT VERNON |
Zip Code | 62864 |
Please comment or provide details below to improve the information on NANCY K KERTZ.
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.