MS. THERESA JEAN ULICHNEY (NPI# 1134155773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134155773 |
| Entity Type | Individual |
| Full Name | MS. THERESA JEAN ULICHNEY |
| Other Name | THERESA CADA |
| Credential | CNP |
| Practice Address |
420 Polifka Dr Shaw Afb SC 29152 |
| Mailing Address |
420 Polifka Dr Shaw Afb SC 29152-5100 |
| Practice Telephone | 8038956812 |
| Practice Fax Number | 8038956030 |
| Mailing Telephone | 8038956812 |
| Mailing Fax Number | 8038956030 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-05-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 00175079 | WA | Nursing Service Providers |
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
A18512 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
AP30007901 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
420 POLIFKA DR |
| City | SHAW AFB |
| State | SC |
| Zip Code | 29152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164046520 | Patti E Busser | Social Worker | 420 Polifka Dr, Shaw Afb, SC 29152-5100 | 2020-06-02 |
| 1568005452 | Hanlon Ignatius Maivelett | Pharmacist | 420 Polifka Dr, Shaw Afb, SC 29152-5100 | 2019-10-23 |
| 1083123020 | Ana N Chavis | Pharmacist | 420 Polifka Dr, Shaw Afb, SC 29152-5100 | 2017-09-21 |
| 1104232701 | Valerie Luisa Villanueva | Physician Assistant | 420 Polifka Dr, Shaw Afb, SC 29152-5100 | 2014-07-03 |
| 1962635771 | Karen Rupp | Family Medicine | 420 Polifka Dr, Shaw Afb, SC 29152 | 2009-08-27 |
| 1881830107 | Ronny Bowman | Optometrist | 420 Polifka Dr, Shaw Afb, SC 29152-5100 | 2008-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487201695 | Ethan Lee Brockett | Dentist | Shaw Afb Dental Clinic, Shaw Afb, AE 29152 | 2019-08-22 |
| 1275066821 | Travis B Grindstaff | General Acute Care Hospital | 411 Polifka Dr, Shaw Afb, SC 29152 | 2017-04-10 |
| 1851791578 | Terrance Walker | Psychologist | 431 Meadow St, Sumter, SC 29152 | 2014-08-29 |
| 1124258967 | Jacqueline Mintz | Nurse Practitioner | 524 Nelson Ave, Shaw Afb, SC 29152 | 2009-07-14 |
| 1396970117 | Jennifer N Steele | Military Health Care Provider | 411 Meadowlark St, Shaw A F B, SC 29152 | 2009-05-22 |
| 1285899146 | Elizabeth Ann Vandevelde | Nurse Practitioner | 129 North Washington, Tuomey Healthcare System, Sumter, SC 29152 | 2008-07-21 |
| 1134211089 | Kibrom T Mehari | Dentist | 449 Shaw Dr, Shaw A F B, SC 29152 | 2006-09-29 |
| 1366415184 | Kimberly Marie Shanks | Nurse Practitioner | 431 Meadowlark Rd, Shaw Afb, SC 29152 | 2006-02-10 |
| 1194710780 | Anthony Shawn Bankes | Family Medicine | 411 Medowlark, Shaw Afb, SC 29152 | 2005-09-20 |
| 1861957516 | Charles Bradford Davis | Physician Assistant | 411 Polifka Dr, Shaw Afb, SC 29152 | 2019-02-07 |
| Find all providers in zip 29152 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659919710 | Christy Marie South | Nurse Practitioner | 81 Pointe Cir Ste D, Greenville, SC 29615-3505 | 2019-12-19 |
| 1598217457 | Amanda Jean Ruby | Nurse Practitioner | 3864 Renee Dr, Myrtle Beach, SC 29579-4108 | 2016-10-26 |
| 1174920847 | Tyra L Taylor | Nurse Practitioner | 2 Maple Tree Ct, Bon Secours Ob-gyn, Greenville, SC 29615-4068 | 2014-11-24 |
| 1407199060 | Victoria Lynn Brassfield | Nurse Practitioner | 1220 Hospital Dr Ste A, Mount Pleasant, SC 29464-3678 | 2013-04-02 |
| 1578825444 | Miriam Faith Criswell | Nurse Practitioner | 727 Se Main St Ste 120, Simpsonville, SC 29681 | 2012-06-15 |
| 1669747341 | Michaela Buchanan French | Nurse Practitioner | 11 Park Creek Drive, Greenville, SC 29605 | 2012-03-14 |
| 1770865511 | Amanda C Naramore | Nurse Practitioner | 343 Old South Way, Mt Pleasant, SC 29464-7854 | 2011-09-19 |
| 1487961876 | Isis Lucia Hart | Nurse Practitioner | 25 Hospital Center Blvd Ste 305, Hilton Head Island, SC 29926-2739 | 2010-09-07 |
| 1952432882 | Billie S Buchanan | Nurse Practitioner | 202 Victoria St, Greer, SC 29651-3436 | 2007-03-09 |
| 1578602546 | Beverly I Huegel | Nurse Practitioner | 4311 Hard Scrabble Rd, Columbia, SC 29229-9422 | 2007-02-06 |
| 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.