MRS. MELISSA LYNN PHELAN (NPI# 1215313143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215313143 |
| Entity Type | Individual |
| Full Name | MRS. MELISSA LYNN PHELAN |
| Other Name | MELISSA LYNN JONES |
| Credential | FNP |
| Practice Address |
122 E Morningside Dr Peoria IL 61614 |
| Mailing Address |
122 E Morningside Dr Peoria IL 61614-2132 |
| Practice Telephone | 3094727382 |
| Mailing Telephone | 3094727382 |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2018-11-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209013000 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4001 W Carrousel Ln, Peoria, IL 616152860 | 3094727382 |
| Street Address |
122 E MORNINGSIDE DR |
| City | PEORIA |
| State | IL |
| Zip Code | 61614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| 1801227707 | Vikram Shah | Pharmacist | 801 W Lake Street, Kroger Pharmacy, Peoria, IL 61614 | 2013-12-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1699390039 | Steven Joel Schlink | Nurse Practitioner | 12920 W Roy Rogers Rd, Peoria, AZ 85383-5334 | 2020-06-11 |
| 1457986929 | Chanelle Christine Maclin | Nurse Practitioner | 504 E Kansas St, Peoria, IL 61603-2554 | 2020-03-05 |
| 1225677495 | Michelle Chacon | Nurse Practitioner | 23201 N 87th Dr, Peoria, AZ 85383-1860 | 2020-01-05 |
| 1689218042 | Patricia Nwakaego Ayemoba | Nurse Practitioner | 16018 N 74th Dr, Peoria, AZ 85382-1810 | 2019-10-29 |
| 1144877267 | Eunice Wright | Nurse Practitioner | 26826 N 85th Dr, Peoria, AZ 85383-3624 | 2019-08-22 |
| 1861057507 | Shawnee Renee Fudurich | Nurse Practitioner | 10230 W Happy Valley Pkwy Ste 100, Peoria, AZ 85383-4255 | 2019-05-08 |
| 1265096895 | Razel Espiritu Hernandez | Nurse Practitioner | 25435 N 115th Ave, Peoria, AZ 85383-9789 | 2019-04-29 |
| 1619435310 | Jennifer Gayle Ries-clark | Nurse Practitioner | 8009 W Salter Dr, Peoria, AZ 85382-4440 | 2019-03-12 |
| Find all providers in PEORIA | ||||
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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.