MRS. HOLLY ANN GATES (NPI# 1063991206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063991206 |
Entity Type | Individual |
Full Name | MRS. HOLLY ANN GATES |
Other Name | MRS. HOLLY RYDER |
Credential | NP-C |
Practice Address |
1506 Sioux Dr Marion IL 62959 |
Mailing Address |
109 California St Po Box 577 Carterville IL 62918-0577 |
Practice Telephone | 6185199200 |
Practice Fax Number | 6189854635 |
Mailing Telephone | 6185199200 |
Mailing Fax Number | 6189854635 |
Enumeration Date | 2018-08-08 |
Last Update Date | 2019-06-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 209017901 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.017901 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
628 N 14th St, Murphysboro, IL 629661807 | 6186872353 | 6186879511 |
Street Address |
1506 SIOUX DR |
City | MARION |
State | IL |
Zip Code | 62959 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538150107 | Danneille C Trujillo-hansen | Clinical Nurse Specialist | 1506 Sioux Dr, Marion, IL 62959-5209 | 2005-11-02 |
1306497052 | Shawnee Health Service and Development Corp | Clinic/Center | 1506 Sioux Dr, Marion, IL 62959-5209 | 2019-09-24 |
1134582471 | Tiffany Todd | Social Worker | 1506 Sioux Dr, Marion, IL 62959-5209 | 2016-04-04 |
1770770133 | Nicky R Turner | Nurse Practitioner | 1506 Sioux Dr, Marion, IL 62959 | 2007-10-01 |
1205036696 | Michael W Adams | Clinic/Center | 1506 Sioux Dr, Marion, IL 62959-5209 | 2007-07-23 |
1528178860 | Kathryn Marie Mcmurphy | Physician Assistant | 1506 Sioux Dr, Marion, IL 62959-5209 | 2006-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
Find all providers in zip 62959 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790391977 | Pamela Jane Clarida | Nurse Practitioner | 1001 E Illinois St, Marion, IL 62959-3711 | 2020-09-22 |
1194330845 | Jamie Jones Hayden | Nurse Practitioner | 134 Willow Springs Rd, Marion, VA 24354-6700 | 2020-09-10 |
1992331714 | Andrea Williams | Nurse Practitioner | 55 Mckenzie Cv, Marion, AR 72364-2661 | 2020-03-13 |
1073159984 | Angela Hamill | Nurse Practitioner | 924 Ar 77, Marion, AR 72364 | 2019-11-26 |
1902466220 | Aimee Wiggins Martin | Nurse Practitioner | 1649 W Highway 76, Marion, SC 29571-6621 | 2019-06-18 |
1801358163 | William Wayne Thomas II | Nurse Practitioner | 2808 Outer Dr, Marion, IL 62959-5207 | 2019-04-04 |
1033670062 | Era Louise Mattingly | Nurse Practitioner | 11522 White Pine Ave, Marion, IL 62959-8379 | 2019-03-31 |
1598223414 | Jeanni A. Gerwin | Nurse Practitioner | 1125 Ellen Kay Dr Ste A, Marion, OH 43302-6358 | 2019-03-10 |
1619431780 | Lisa Dawn Powell | Nurse Practitioner | 2921 Hwy 77 S Ste 12-13, Marion, AR 72364-2367 | 2019-01-23 |
1285110551 | Marcie Ann Ellington | Nurse Practitioner | 518 W Gum St, Marion, KY 42064-1516 | 2018-07-19 |
Find all providers in MARION |
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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.