JENNIFER LANZ (NPI# 1114343225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114343225 |
| Entity Type | Individual |
| Full Name | JENNIFER LANZ |
| Credential | APN |
| Practice Address |
1302 Franklin Ave Suite 4500 Normal IL 61761-3551 |
| Practice Telephone | 3095568300 |
| Practice Fax Number | 3095568293 |
| Mailing Telephone | 3095568300 |
| Mailing Fax Number | 3095568293 |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
209011284 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP PIN | IL1307 | 01 |
| Street Address |
1302 FRANKLIN AVE SUITE 4500 |
| 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 |
| 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 |
| 1033494455 | Maneesha T Joseph | Registered Nurse | 1302 Franklin Ave, Suite 3400, Normal, IL 61761-3551 | 2011-10-17 |
| 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 | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871500686 | Sheryl Daun Jenkins | Nurse Practitioner | 1300 Franklin Ave, Suite 100, Normal, IL 61761-3592 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759461 | Sarah Westerman | Nurse Practitioner | 721 Dover Ct, Pingree Grove, IL 60140-9181 | 2020-10-28 |
| 1609485424 | Intensive Karen LLC | Nurse Practitioner | 612 Mulford St Apt 503, Evanston, IL 60202-3531 | 2020-07-28 |
| 1609484591 | Jennifer Kuczero | Nurse Practitioner | 4059 W 89th Pl, Hometown, IL 60456-1202 | 2020-07-16 |
| 1205452489 | Aneta Trybula | Nurse Practitioner | 10604 W 154th Pl, Orland Park, IL 60462-6025 | 2020-06-23 |
| 1740742170 | Jenna C Reeh | Nurse Practitioner | 1740 W Taylor St # 605e, Chicago, IL 60612-7232 | 2019-04-04 |
| 1588125116 | Sherryl Estorque | Nurse Practitioner | 9033 W Heathwood Cir, Niles, IL 60714-5807 | 2019-03-27 |
| 1992276497 | Laura Beth Miller | Nurse Practitioner | 302 W Hay St Ste 110, Decatur, IL 62526-4167 | 2018-12-09 |
| 1932674322 | Ashleigh M Poptic | Nurse Practitioner | 675 N St Claire St Ste 19-100, Galter Pavilion, Chicago, IL 60611-5969 | 2018-10-11 |
| 1215415039 | Julieanne Ferguson | Nurse Practitioner | 251 E Huron St Dept Of, Chicago, IL 60611-2908 | 2018-08-02 |
| 1275024523 | Lateisha Nicole Fort | Nurse Practitioner | 1222 E 170th St, South Holland, IL 60473-3558 | 2018-05-22 |
| Find all providers with the same taxonomy | ||||
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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.