NELLIE NICOLE SAMPLE (NPI# 1275007809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275007809 |
| Entity Type | Individual |
| Full Name | NELLIE NICOLE SAMPLE |
| Other Name | NELLIE NICOLE SWOBODA |
| Credential | CPHT |
| Practice Address |
5500 E Kellogg Dr Wichita KS 67218-1607 |
| Mailing Address |
1402 W Calvert St Wichita KS 67217-2722 |
| Practice Telephone | 3166852221 |
| Mailing Telephone | 3169328020 |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 14-107167 | KS | Pharmacy Service Providers |
| Street Address |
5500 E KELLOGG DR |
| City | WICHITA |
| State | KS |
| Zip Code | 67218-1607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729673 | Catherine A Toomey | Physician Assistant | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2005-06-13 |
| 1225642051 | Mark Clark | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-08-31 |
| 1598377483 | Rachel Elaine Donis | Occupational Therapist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-08-20 |
| 1164030060 | Jacob Michael Goeser | Optometrist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-07-16 |
| 1992329262 | Aimee Boriboun | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-06-02 |
| 1760012900 | Lisa Christy | Nurse Practitioner | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2020-01-15 |
| 1790324499 | Linda Walim Nola | Pharmacist | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-12-27 |
| 1164078010 | Daniel Steven Haley | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-16 |
| 1790331783 | Jason Alan Jester | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-15 |
| 1629624770 | Emily Suzanne Stuart | Social Worker | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2019-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544392 | Diana Ho | Optometrist | 980 Oliver Street, Wichita, KS 67218 | 2020-07-03 |
| 1134773690 | Lily Lopez | Nurse's Aide | 5107 E Kellogg Drive, Wichita, KS 67218 | 2019-08-01 |
| 1750862512 | Kelsi Wenger | Student in an Organized Health Care Education/Training Program | 5500 E Kellog Dr, Wichita, KS 67218 | 2018-08-28 |
| 1770038937 | Hair Replacement Clinic | Specialist | 1815 S Windsor, Wichita, KS 67218 | 2016-08-17 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 1124460787 | Teri Kitchen | Social Worker | 3414 Kinkaid, Wichita, KS 67218 | 2013-07-24 |
| 1053660142 | Glenda Rodgers-lawless, Ph.d., Lcpc, Pa | Community/Behavioral Health | 4601 E Douglas, Wichita, KS 67218 | 2012-09-05 |
| 1649541848 | Stephen Rhinehart | Registered Nurse | 5500 E Kellogg Dr., Wichita, KS 67218 | 2012-01-19 |
| 1457666927 | Recovery Services Council Inc. | Point of Service | 1611 South Rutan, Wichita, KS 67218 | 2010-08-09 |
| 1043535867 | Melissa A Weinley | Respiratory Therapist, Registered | 5500 East Kellog Dr, Wichita, KS 67218 | 2010-04-05 |
| Find all providers in zip 67218 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871966713 | Erin Padfield | Pharmacy Technician | 3333 E Central Ave, Wichita, KS 67208-3105 | 2015-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225513039 | Brent Keffer | Pharmacy Technician | 415 W 17th St, Lawrence, KS 66044-4109 | 2018-09-27 |
| 1972999688 | Karen Gell | Pharmacy Technician | 8101 West 151st Street, Overland Park, KS 66223 | 2015-04-09 |
| 1881090082 | Devin Lee Burghart-martin | Pharmacy Technician | 2343 Ne 39th St, Topeka, KS 66617-3714 | 2014-11-15 |
| 1598843260 | Connie Villers | Pharmacy Technician | 11240 Tucker Rd, Pleasanton, KS 66075-8402 | 2006-11-01 |
| 1568060911 | Erica J Severson | Pharmacy Technician | 509 State St, Augusta, KS 67010-1107 | 2020-10-16 |
| 1023622578 | Jennifer Hoover | Pharmacy Technician | 3630 Sw Wanamaker Rd, Topeka, KS 66614-4528 | 2020-09-02 |
| 1447873393 | Sheila Rehder | Pharmacy Technician | 11300 Corporate Ave Ste 120, Lenexa, KS 66219-1374 | 2020-05-27 |
| 1568933539 | Katherine Smart | Pharmacy Technician | 6829 Sw 29th St, Topeka, KS 66614-6083 | 2018-12-16 |
| 1225522683 | Alonna Danae Galvan | Pharmacy Technician | 1008 Se Louis Dr, Mulvane, KS 67110-1109 | 2018-06-19 |
| 1639669054 | Tanya Vivian Hooglugt | Pharmacy Technician | 1510 Ohio St, Augusta, KS 67010-2157 | 2018-05-10 |
| 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.