JUSTIN EGOVILLE (NPI# 1336410851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336410851 |
| Entity Type | Individual |
| Full Name | JUSTIN EGOVILLE |
| Credential | NP |
| Practice Address |
80001 State Rd. Mhm Correctional Services, Mod II Philadelphia PA 19136-0000 |
| Mailing Address |
257 Winding Way Merion Station PA 19066-1225 |
| Practice Telephone | 2156240797 |
| Mailing Telephone | 6106689528 |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP011762 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
80001 STATE RD. MHM CORRECTIONAL SERVICES, MOD II |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19136-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801361274 | Mary Ann Theresa Mcintyre | Social Worker | 3501 Solly Avenue, Philadelphia, PA 19136 | 2018-10-11 |
| 1396227732 | Chiropractor Dynamic PC | Chiropractor | 7337 Frankford Ave, Philadelphia, PA 19136 | 2018-09-01 |
| 1932689478 | Jenna Nicole Harrison | Physical Therapist | 7343-7345 Frankford Avenue, Philadelphia, PA 19136 | 2018-08-15 |
| 1063932069 | Rachel Alexa Allen | Counselor | 3254 Teesdale Street, Philadelphia, PA 19136 | 2017-06-21 |
| 1962944371 | Erin Hartey | Counselor | 4323 Vista St, Phila, PA 19136 | 2016-11-16 |
| 1932657715 | Janice Lisette Frisby | Counselor | 8454 Jackson Street, Philadelphia, PA 19136 | 2016-09-21 |
| 1326428541 | General Healthcare Agency | Community/Behavioral Health | 4616 Ashville St, Philadelphia, PA 19136 | 2015-06-03 |
| 1215314653 | Sincere Home Health Care Service | In Home Supportive Care | 4510 Aberdale Road, Philadelphia, PA 19136 | 2015-05-06 |
| 1497159420 | Creative Steps Incorporated | Clinic/Center | 8045 Frankford Avenue, Philadelphia, PA 19136 | 2014-10-20 |
| 1316379779 | Epic Physicians L.L.C. | Clinic/Center | 8021 Frankford Ave, Philadelphia, PA 19136 | 2013-08-07 |
| Find all providers in zip 19136 | ||||
| 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 |
|---|---|---|---|---|
| 1770199341 | Nicole Kassandra Carissimi | Nurse Practitioner | 1618 S 19th St, Philadelphia, PA 19145-1439 | 2020-09-19 |
| 1770192775 | Lisa Ghiloni | Nurse Practitioner | 6809 N 10th St, Philadelphia, PA 19126-2906 | 2020-07-26 |
| 1104440940 | Patricia Cecilia Castillo | Nurse Practitioner | 49204 Delaire Landing Rd, Philadelphia, PA 19114-5329 | 2020-06-06 |
| 1184271074 | Clement John | Nurse Practitioner | 3253 N 6th St, Philadelphia, PA 19140-5644 | 2019-08-25 |
| 1558915967 | Latoya Mohammed | Nurse Practitioner | 3300 Henry Ave Ste 3n, Philadelphia, PA 19129-1141 | 2019-07-25 |
| 1225427867 | Alison Ercole | Nurse Practitioner | 4301 Spruce St, Apt A 414, Philadelphia, PA 19104-4760 | 2015-01-20 |
| 1790195386 | Thomasean Britten | Nurse Practitioner | 449 Parker Ave, Philadelphia, PA 19128-4403 | 2014-05-05 |
| 1891048377 | Elizabeth Ann Milburn | Nurse Practitioner | 1528 Walnut St Ste 1414, Philadelphia, PA 19102-3610 | 2012-10-20 |
| 1396050720 | Dwayne M Toomer | Nurse Practitioner | 718 Addison St Apt E, Philadelphia, PA 19147-1353 | 2010-08-10 |
| 1225353840 | Noel Palmer | Nurse Practitioner | 16270 Highway 21 S, Philadelphia, MS 39350-7762 | 2010-04-07 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19136 |
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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.