AMY LUCKETT ENIS (NPI# 1194273565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194273565 |
| Entity Type | Individual |
| Full Name | AMY LUCKETT ENIS |
| Credential | PMHNP |
| Practice Address |
8603 Broadway St Ste 107 Pearland TX 77584-8172 |
| Practice Telephone | 2819975515 |
| Mailing Telephone | 2819975515 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2019-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP141672 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
901683 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00026834 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 N State St, Jackson, MS 392164500 | 6019841000 |
| Street Address |
8603 BROADWAY ST STE 107 |
| City | PEARLAND |
| State | TX |
| Zip Code | 77584-8172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033412366 | Priceline Pharmacy | Pharmacy | 8603 Broadway St Ste 107, Pearland, TX 77584-8172 | 2010-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181281 | Joyce Ann Fugit | Technician | 8024 Serenity Dr., Pearland, TX 77584 | 2020-10-16 |
| 1558916403 | Houston Mint Dentistry, Pllc | Dentist | 12568 Broadway St Ste 140, Pearland, TX 77584 | 2019-08-07 |
| 1982259198 | Pearland Unicare Pharmacy LLC | Pharmacy | 10970 Shadow Creek Parkway Suite 110.2, Pearland, TX 77584 | 2019-08-05 |
| 1972155869 | Parastoo Natasha Coselli | Dentist | 2811 Buisness Dr Unit 105, Pearland, TX 77584 | 2019-07-11 |
| 1679042030 | Dorothy B Smith-hubbard | Counselor | 919 Norfolk Dr., Pearland, TX 77584 | 2018-11-15 |
| 1720562499 | Kelly Jean Barba | Physical Therapy Assistant | 3406 Businesses Center Dr, Pearland, TX 77584 | 2018-09-19 |
| 1437631884 | Laura Gillet | Registered Nurse | 3306 Summerwood Lane, Pearland, TX 77584 | 2018-09-02 |
| 1881176204 | Sharry Magne Rivera Estrella | Registered Nurse | 11900 Shadow Creek Parkway Apt 1311, Pearland, TX 77584 | 2018-09-01 |
| 1962982264 | Shara Elizabeth Watts | Occupational Therapist | 12001 Shadow Creek Pwky, Pearland, TX 77584 | 2018-08-16 |
| 1457830861 | Melvin Thomas | Dentist | 3215 Souther Green Drive, Pearland, TX 77584 | 2018-08-08 |
| Find all providers in zip 77584 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114427309 | Kelly Michelle Martinez | Nurse Practitioner | 2006 Broadway St Ste 101, Pearland, TX 77581-5559 | 2018-02-14 |
| 1982087581 | Mary Katherine Hill | Nurse Practitioner | 12234 Shadow Creek Parkway, Blgd 4 Suite 104, Pearland, TX 77584-7330 | 2015-07-01 |
| 1982249728 | Faiza Haque | Nurse Practitioner | 12234 Shadow Creek Pkwy Ste 4104, Pearland, TX 77584-7333 | 2019-11-15 |
| 1033693601 | Olga Awuor Ochieng | Nurse Practitioner | 12234 Shadow Creek Pkwy Ste 4104, Pearland, TX 77584-7333 | 2018-09-19 |
| 1962904722 | Jellirica Peters | Nurse Practitioner | 12234 Shadow Creek Pkwy, Pearland, TX 77584-7330 | 2018-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537857 | Julius Abam | Nurse Practitioner | 634 Rustic Trl, Midlothian, TX 76065-2267 | 2020-10-30 |
| 1750981619 | Suvekchya Subedi | Nurse Practitioner | 4032 Vista Mar Drive, Euless, TX 76040 | 2020-10-29 |
| 1821698754 | Christienne Felice Solis Callasan | Nurse Practitioner | 1010 Palos Verdes Blvd, Arlington, TX 76017-1780 | 2020-10-29 |
| 1932709201 | Aftercare, Pllc | Nurse Practitioner | 2000 Crawford St Ste 1221, Houston, TX 77002-9000 | 2020-10-27 |
| 1497355929 | Hector Medellin IIi | Nurse Practitioner | 6014 County Road 4068, Kemp, TX 75143-2600 | 2020-10-26 |
| 1639778947 | Aj Psychiatry Pllc | Nurse Practitioner | 1920 N Coit Rd Ste 219, Richardson, TX 75080-2832 | 2020-10-19 |
| 1154929735 | Valerie Michelle Vaughn-smith | Nurse Practitioner | 3105 Rockbrook Dr, Kilgore, TX 75662-2251 | 2020-10-15 |
| 1700483468 | Knd Behavioural Health Clinic | Nurse Practitioner | 103 Herrington Dr, Mansfield, TX 76063-7615 | 2020-10-06 |
| 1184231805 | Tihana Sladic | Nurse Practitioner | 1515 S Capital of Texas Hwy Ste 300&301, Austin, TX 78746-6579 | 2020-09-27 |
| 1679189369 | Charity Chioma Durant | Nurse Practitioner | 2310 Echo Ct, Rowlett, TX 75088-1534 | 2020-09-18 |
| 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.