JEANINE R WILLIS (NPI# 1356776975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356776975 |
| Entity Type | Individual |
| Full Name | JEANINE R WILLIS |
| Credential | CNP |
| Practice Address |
10325 Dewhurst Rd Elyria OH 44035-8403 |
| Practice Telephone | 4404149260 |
| Practice Fax Number | 2162015581 |
| Mailing Telephone | 4404149260 |
| Mailing Fax Number | 2162015581 |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2020-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
COA.15100-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0096370 | 05 |
| Street Address |
10325 DEWHURST RD |
| City | ELYRIA |
| State | OH |
| Zip Code | 44035-8403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003802141 | Timothy Plank | Family Medicine | 10325 Dewhurst Rd, Elyria, OH 44035 | 2005-09-23 |
| 1841715737 | Carrie Louise Ortiz | Nurse Practitioner | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2017-08-11 |
| 1043614704 | William J Scott Dpm Inc | Podiatrist | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2014-10-09 |
| 1669695516 | William J Scott | Podiatrist | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2007-04-10 |
| 1831138601 | Matthew S Schaeffer | Family Medicine | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2006-06-06 |
| 1356315949 | Diane Huey | Internal Medicine | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2006-02-13 |
| 1154391647 | Kamaleswary Ravichandran | Internal Medicine | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2006-01-25 |
| 1831169333 | Deborah Anne Vicario | Family Medicine | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2006-01-25 |
| 1639149131 | Abdelkarim Waness | Internal Medicine | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2006-01-25 |
| 1497733075 | Mushtaq Mahmood | Internal Medicine | 10325 Dewhurst Rd, Ohio Medical Group, Elyria, OH 44035-8403 | 2006-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514546 | Monica Sue Lane | Homemaker | 244 13th St, Elyria, OH 44035 | 2020-10-07 |
| 1457958993 | Joaquin Deandre Page | Homemaker | 116 Parkview Ct, Elyria, OH 44035 | 2020-10-07 |
| 1740887751 | Kelley Jean Duga | Home Health Aide | 46058 Russia Rd, Elyria, OH 44035 | 2020-10-02 |
| 1407477946 | Ashley Langer | Nurse Practitioner | 660 E Broad St, Elyria, OH 44035 | 2020-05-06 |
| 1518593730 | Scott Michael Hartman | Nurse Practitioner | 630 East River Streer, Elyria, OH 44035 | 2020-03-19 |
| 1609415793 | Melanie Scott | Registered Nurse | 830 East Broad St, Uh Hospitals Elyria, Elyria, OH 44035 | 2020-01-06 |
| 1922647478 | Hyatt Family Dental, LLC | Dentist | 301 East Avenue, Elyria, OH 44035 | 2020-01-02 |
| 1255988051 | Ashlee Marie Reale | Student in an Organized Health Care Education/Training Program | 347 Middle Blvd #210, Elyria, OH 44035 | 2019-08-26 |
| 1821656380 | Amber Mahone | Case Manager/Care Coordinator | 342 Midway Blvd Ste 210, Elyria, OH 44035 | 2019-05-30 |
| 1548788151 | Robin Lee Newhart | Physical Therapist | 1885 Lake Avenue, Elyria, OH 44035 | 2017-09-03 |
| Find all providers in zip 44035 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407477946 | Ashley Langer | Nurse Practitioner | 660 E Broad St, Elyria, OH 44035 | 2020-05-06 |
| 1891345583 | Amy L Gordon | Nurse Practitioner | 1532 Abbe Rd S, Elyria, OH 44035-7349 | 2019-09-16 |
| 1700441862 | Candice Davis | Nurse Practitioner | 2007 Fowl Rd, Elyria, OH 44035-4477 | 2019-05-04 |
| 1568937324 | Marianne Jeanette Parker | Nurse Practitioner | 134 Buckingham Dr, Elyria, OH 44035-1706 | 2018-10-09 |
| 1144843673 | Johnna Diaz | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2020-05-19 |
| 1295357911 | Denise N Dalton | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2020-05-15 |
| 1487292272 | Amy S Newton | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2019-12-12 |
| 1295387231 | Stephanie Christina Flynn | Nurse Practitioner | 630 E River St, Elyria, OH 44035-5902 | 2019-07-10 |
| 1003384207 | Leslie A Strodtbeck | Nurse Practitioner | 1120 E Broad St, Elyria, OH 44035-6306 | 2018-11-06 |
| 1841715737 | Carrie Louise Ortiz | Nurse Practitioner | 10325 Dewhurst Rd, Elyria, OH 44035-8403 | 2017-08-11 |
| Find all providers in ELYRIA | ||||
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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.