TAMARA K CANTERBURY (NPI# 1255483772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255483772 |
| Entity Type | Individual |
| Full Name | TAMARA K CANTERBURY |
| Credential | APRN |
| Practice Address |
2537 Eisenhower Rd Ottawa KS 66067-9482 |
| Mailing Address |
Po Box 677 Ottawa KS 66067-0677 |
| Practice Telephone | 7852423780 |
| Practice Fax Number | 7852426397 |
| Mailing Telephone | 7852423780 |
| Mailing Fax Number | 7852426397 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2016-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
APRN 53-74343-09 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200439780A | 05 | |
| KS | 200439780E | 05 |
| Street Address |
2537 EISENHOWER RD |
| City | OTTAWA |
| State | KS |
| Zip Code | 66067-9482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133032 | Gretchen L Trendel | Clinical Nurse Specialist | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2005-09-08 |
| 1093314338 | Rebecca Herrig | Counselor | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2020-10-19 |
| 1609418763 | Sospeter Otieno | Clinical Nurse Specialist | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2019-10-10 |
| 1467018721 | Marie E Schulte | Counselor | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2019-05-13 |
| 1427512177 | Lorene Martins | Counselor | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2019-01-28 |
| 1487149522 | Jade M Brake | Counselor | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2018-06-29 |
| 1285128603 | Abbey Marie Hope | Counselor | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2018-06-19 |
| 1548768880 | Diamone D Sipe | Counselor | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2018-01-31 |
| 1447770284 | Holly Smith | Marriage & Family Therapist | 2537 Eisenhower Rd, Ottawa, KS 66067 | 2017-06-22 |
| 1154879120 | Samantha Cervetti | Social Worker | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2016-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482870 | Katie Jean Turpin | Occupational Therapist | 3901 S Main St, Ottawa, KS 66067 | 2020-03-18 |
| 1619526464 | Jennifer Raybern | Specialist/Technologist | 1001 S Cedar St, Ottawa, KS 66067 | 2019-09-04 |
| 1508419938 | Custom Dental of Ottawa, Pa | Clinic/Center | 2030 S Princeton St, Ottawa, KS 66067 | 2019-07-24 |
| 1861948507 | Jeffrey Byrne Kelley | Pharmacist | 2101 S Princeton Rd, Ottawa, KS 66067 | 2016-09-01 |
| 1619185188 | Vintage Park At Ottawa LLC | Assisted Living Facility | 2250 S Elm St, Ottawa, KS 66067 | 2007-05-18 |
| 1356423495 | Ottawa Oral Surgery Lc | Dentist | 107 E 23rd St, Ste 3 Ottawa Oral Surgery Lc, Ottawa, KS 66067 | 2006-10-19 |
| 1669564332 | Sandra K Staneart | Nurse Practitioner | 1302 South Main St, Suite 1, Ottawa, KS 66067 | 2006-09-29 |
| 1467553214 | Nancy L Pauw | Social Worker | 2476 Reno Rd, Ottawa, KS 66067 | 2006-09-26 |
| 1700847043 | T.a. Rainbolt, Dds, P.a. | Dentist | 1334 S. Main Street, Ottawa, KS 66067 | 2006-03-28 |
| 1659341634 | Milton Laverne Sampson | Nurse Anesthetist, Certified Registered | 1301 S Main, Ottawa, KS 66067 | 2006-01-24 |
| Find all providers in zip 66067 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133032 | Gretchen L Trendel | Clinical Nurse Specialist | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2005-09-08 |
| 1609418763 | Sospeter Otieno | Clinical Nurse Specialist | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2019-10-10 |
| 1780786533 | Diane Zadra Drake | Clinical Nurse Specialist | 2537 Eisenhower Rd, Ottawa, KS 66067-9482 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649331281 | Tamara L Farmer | Clinical Nurse Specialist | 802 West Broadway, Stafford, KS 67578-0309 | 2006-12-13 |
| 1013904960 | Susan Hasselle | Clinical Nurse Specialist | 900 Massachusetts St, Lawrence, KS 66044-2868 | 2005-10-04 |
| 1205830783 | Deborah C Murphy | Clinical Nurse Specialist | 9415 E Harry St, Ste 800, Wichita, KS 67207-5084 | 2005-06-13 |
| 1356345805 | Diane A Gaunt | Clinical Nurse Specialist | 9415 E Harry, Bldg 800, Wichita, KS 67207-5072 | 2005-06-10 |
| 1881094902 | Ashley Melugin | Clinical Nurse Specialist | 1919 N Amidon Ave, Ste 130, Wichita, KS 67203-2117 | 2014-08-26 |
| 1548557564 | Diane G Knapic | Clinical Nurse Specialist | 8000 W 127th St, Overland Park, KS 66213-2714 | 2011-06-29 |
| 1073781407 | Annette Stagg | Clinical Nurse Specialist | 480 S Rogers Rd, Olathe, KS 66062-1706 | 2008-02-19 |
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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.