GLORIA MICHELLE PAUL EDACHERIL (NPI# 1144502253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144502253 |
| Entity Type | Individual |
| Full Name | GLORIA MICHELLE PAUL EDACHERIL |
| Credential | NP |
| Practice Address |
20 Progress Point Pkwy Ste 108 O Fallon MO 63368 |
| Mailing Address |
20 Progress Point Pkwy Ste 108 O Fallon MO 63368-2207 |
| Practice Telephone | 6363442400 |
| Practice Fax Number | 6363442401 |
| Mailing Telephone | 6363442400 |
| Mailing Fax Number | 6363442401 |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2018-09-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 2011011839 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2011011839 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2620 N Westwood Blvd, Poplar Bluff, MO 639013396 | 5737272640 |
| Street Address |
20 PROGRESS POINT PKWY STE 108 |
| City | O FALLON |
| State | MO |
| Zip Code | 63368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194923151 | Laura L Hill | Nurse Practitioner | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2007-07-10 |
| 1629506522 | Daniel Martin Weisel | Family Medicine | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2017-05-23 |
| 1861873077 | Caitlin Sue Rogers | Family Medicine | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368 | 2015-06-12 |
| 1295155000 | Genevieve Catherine Matthews | Internal Medicine | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2014-04-18 |
| 1780020495 | Natasha Brooke Fresenburg | Physician Assistant | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2013-05-21 |
| 1710240221 | Devin Bell | Family Medicine | 20 Progress Point Pkwy Ste 108, O Fallon, MO 63368-2207 | 2012-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on GLORIA MICHELLE PAUL EDACHERIL.
| 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.