MS. JUDY WILBURN NIELSEN (NPI# 1255434858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255434858 |
| Entity Type | Individual |
| Full Name | MS. JUDY WILBURN NIELSEN |
| Other Name | JUDY WILBURN REMIS |
| Credential | PA-C |
| Practice Address |
4771 S Cleveland Ave Fort Myers FL 33907-1317 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393439800 |
| Practice Fax Number | 2393439848 |
| Mailing Telephone | 2393439800 |
| Mailing Fax Number | 2393439848 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA545 OK | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 100035600 | 05 | |
| OK | 200016420A | 05 | |
| OK | 200078200A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4785 East 91st, Suite B, Tulsa, OK 74137 | 9185567845 | 9185567849 |
| Street Address |
4771 S CLEVELAND AVE |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907-1317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396744827 | Andrew H Singh | Preventive Medicine | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2005-07-18 |
| 1235789926 | Angela Battig | Physician Assistant | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2019-09-16 |
| 1013422716 | Alex Leyon Lagodzinski | Nurse Practitioner | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2017-12-05 |
| 1508395633 | Maria Elisa Marconi | Physician Assistant | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2017-06-12 |
| 1669924452 | Stacy Parker | Nurse Practitioner | 4771 S Cleveland Ave, Fort Myers, FL 33907 | 2016-10-27 |
| 1356893499 | Heidi Alexander | Nurse Practitioner | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2016-10-25 |
| 1083072094 | Susan Whatley | Nurse Practitioner | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2016-02-04 |
| 1740658368 | Brittanee Donovan | Physician Assistant | 4771 S Cleveland Ave, Fort Myers, FL 33907 | 2015-09-14 |
| 1164823043 | Sarah Mcgregor | Nurse Practitioner | 4771 S Cleveland Ave, Fort Myers, FL 33907 | 2014-09-10 |
| 1740697978 | Lee Memorial Health System | General Practice | 4771 S Cleveland Ave, Fort Myers, FL 33907-1317 | 2014-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679360 | Samantha Lee Zavada | Physician Assistant | 9459 Silver Pine Loop, Fort Myers, FL 33967-5152 | 2020-11-07 |
| 1811597198 | Alexis Thraen | Physician Assistant | 4536 Winkler Ave Apt 204, Fort Myers, FL 33966-7013 | 2020-10-27 |
| 1265065247 | Marathon Health LLC | Physician Assistant | 1660 Electric Ln, Fort Myers, FL 33917-3946 | 2020-02-18 |
| 1710510813 | Noshaba Khaliq | Physician Assistant | 17549 Cherry Ridge Ln, Fort Myers, FL 33967-5138 | 2020-02-17 |
| 1699307389 | Colleen Mcgonagle | Physician Assistant | 12700 Creekside Ln Ste 101, Fort Myers, FL 33919-3356 | 2020-02-10 |
| 1922643238 | Abigail Christine Reed | Physician Assistant | 16230 Summerlin Rd Ste 213-218, Fort Myers, FL 33908-5768 | 2019-11-11 |
| 1245899756 | Aileen Fiallo | Physician Assistant | 4571 Colonial Blvd Ste 210, Fort Myers, FL 33966-1156 | 2019-06-08 |
| 1316422199 | Angelia Lynette Sakyi-agyekum | Physician Assistant | 8291 Dani Dr Ste 101a, Fort Myers, FL 33966-8009 | 2018-09-27 |
| 1225547029 | Irene Julian | Physician Assistant | 14090 Metropolis Ave Ste 102, Fort Myers, FL 33912-4451 | 2017-09-25 |
| 1134653827 | Matthew Jeremy Blakemore | Physician Assistant | 6150 Diamond Centre Ct Ste 1300, Fort Myers, FL 33912-4367 | 2017-04-19 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
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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.