SHANNON M MENTZER


Address: 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434
Phone: 5633242992

SHANNON M MENTZER (NPI# 1184957839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184957839
Entity Type Individual
Full Name SHANNON M MENTZER
Other Name SHANNON M WOOLARD
Credential ARNP
Practice Address 1236 E Rusholme St
Suite 300
Davenport
IA 52803-2434
Practice Telephone 5633242992
Practice Fax Number 5633248562
Mailing Telephone 5633242992
Mailing Fax Number 5633248562
Enumeration Date 2009-09-14
Last Update Date 2009-09-14
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
A088931 IA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1236 E RUSHOLME ST
SUITE 300
City DAVENPORT
State IA
Zip Code 52803-2434

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912986837 Prakash R Bontu Internal Medicine 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 2006-01-10
1942606413 Ellen Terese Holm Nurse Practitioner 1236 E Rusholme St, Ste 300, Davenport, IA 52803-2434 2014-11-11
1619228392 Meredith Lee Hodgson Nurse Practitioner 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 2012-09-21
1720382542 Julie Ann Shereda Nurse Practitioner 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 2011-01-08
1760792683 Cynthia D Burkholder Nurse Practitioner 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 2010-10-13
1497080709 Srikanth Reddy Kasula Internal Medicine 1236 E Rusholme St, Ste 300, Davenport, IA 52803-2434 2009-10-05
1538353784 Paula Jean Bryant Nurse Practitioner 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 2007-08-30
1689724700 Denise Elaine Antle Clinical Nurse Specialist 1236 E Rusholme St, Davenport, IA 52803-2473 2007-01-11
1871687087 Michael Joseph Gimbel IIi Internal Medicine 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 2006-10-03
1104936087 Shawna Kaye Duske Nurse Practitioner 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 2006-08-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679189971 Amber Rae Rupiper Physician Assistant 518 Locus Street, Davenport, IA 52803 2020-09-22
1558869321 Devan Louis Depauw Physician Assistant 1227 East Rusholme St., Davenport, IA 52803 2018-01-26
1215383070 Brittney N Hughes Nurse Practitioner 1228 E Rusholme Street, Suite 3020, Davenport, IA 52803 2016-05-11
1992138747 Sarah Beth Schlickman Nurse Practitioner 1228 E Rusholme St Ste 3020, Davenport, IA 52803 2013-08-15
1154763845 Leslie A Poston Nurse Practitioner 1228 E. Rushome Street, Mob I, Suite 2100, Davenport, IA 52803 2013-07-23
1083878896 Jolene Marie Dague Dentist 1905 N. Main St, Davenport, IA 52803 2008-07-11
1952436370 Joann C Milani Psychologist 1503 Brady Street, Davenport, IL 52803 2007-02-23
1942343579 Lisa Clare Ploehn Pharmacist 129 West Locust Street, Davenport, IA 52803 2007-02-14
1366597957 Cathleen Ann Clark Social Worker 1706 N Brady, Suite 204, Davenport, IA 52803 2007-01-24
1184781940 William Burke Ltd Durable Medical Equipment & Medical Supplies 129 West Locust, Davenport, IA 52803 2007-01-02
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1932712080 Ana Maria Delinski Nurse Practitioner 325 Nevada Loop Rd, Davenport, FL 33897-5611 2020-08-28
1508475369 Kisha Kay Blunk Nurse Practitioner 5374 Eastern Ave Ste 100, Davenport, IA 52807-2719 2020-07-28
1184252447 Jean Carlos Torres Davila Nurse Practitioner 296 Arbor Lakes Dr, Davenport, FL 33896-8167 2020-03-31
1760012835 Angela Marie Escobar Nurse Practitioner 537 Westwind Dr, Davenport, FL 33896-6613 2020-01-17
1467091660 Jennifer G Kirkland Nurse Practitioner 105 Park Place Blvd Ste A, Davenport, FL 33837-6870 2020-01-06
1831738483 Jonathan Torres Pabon Nurse Practitioner 464 Sardinia Cir, Davenport, FL 33837-5863 2019-12-31
1477114460 Christine Marie Pales Nurse Practitioner 2972 Bella Vista Dr, Davenport, FL 33897-3680 2019-06-21
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Competitor

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City DAVENPORT
Zip Code 52803

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Dataset Information

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.

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