MAVIS KISSEADOO (NPI# 1366081887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366081887 |
| Entity Type | Individual |
| Full Name | MAVIS KISSEADOO |
| Credential | PMHNP |
| Practice Address |
10208 Hickory Ridge Rd Apt 302 Columbia MD 21044-4688 |
| Practice Telephone | 6672006144 |
| Mailing Telephone | 6672006144 |
| Enumeration Date | 2020-01-01 |
| Last Update Date | 2020-01-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R205356 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10208 HICKORY RIDGE RD APT 302 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21044-4688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699331 | Brightview Columbia, LLC | Alzheimer Center (Dementia Center) | 6670 Martin Road, Columbia, MD 21044 | 2020-11-03 |
| 1689291544 | Diana Matthews | Physical Therapist | 6016 Jerrys Drive, Columbia, MD 21044 | 2020-06-26 |
| 1902380926 | Bagiwa Healthcare Services LLC | Nursing Care | 10630 Little Patuxent Park Way, Suite 314i, Colombia, MD 21044 | 2018-09-17 |
| 1295228245 | April Bloom Assisted Living, LLC | Assisted Living Facility | 5037 East Durham Rd, Columbia, MD 21044 | 2018-06-13 |
| 1437659562 | La Shawna A Obame | Counselor | 10451 Twin Rivers Rd Ste 100, Columbia, MD 21044 | 2018-02-15 |
| 1205335262 | Rashida Annette Winestock | Registered Nurse | 10440 Little Patuxent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1215436274 | Terri Lynn Buzby | Registered Nurse | 10440 Little Patuxuent Pkwy 800, Columbia, MD 21044 | 2018-02-06 |
| 1134628191 | Sarah Elizabeth Stiltner | Registered Nurse | 10440 Little Patuxent Pkwy Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1326547381 | David Oliver Sloan Jr. | Registered Nurse | 10440 Little Patuxent Parkway Suite 800, Columbia, MD 21044 | 2018-02-06 |
| 1467950980 | Jill Sheppard Davenport | Nutritionist | 10801 Hickory Ridge Rd Suite 215, C/o Holistic Child Psychiatry, Columbia, MD 21044 | 2018-01-30 |
| Find all providers in zip 21044 | ||||
| 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 |
|---|---|---|---|---|
| 1851906879 | Claudine Njob | Nurse Practitioner | 5500 Knoll North Dr Ste 220, Columbia, MD 21045-2362 | 2020-09-15 |
| 1942768528 | American Psychiatric Care LLC | Nurse Practitioner | 8895 Centre Park Dr Ste E2, Columbia, MD 21045-1966 | 2019-03-04 |
| 1700341948 | Anu John | Nurse Practitioner | G. Werber Bryan Psychiatric Hospital, 220 Faison Drive, Columbia, SC 29203 | 2019-02-01 |
| 1457838633 | Lisa Eunjoo Sohn | Nurse Practitioner | 6310 Stevens Forest Rd Ste 100, Columbia, MD 21046-3208 | 2018-07-20 |
| 1558864157 | Yetunde Olaleye | Nurse Practitioner | 7067 Columbia Gateway Dr Ste 108, Columbia, MD 21046-3407 | 2018-03-10 |
| 1538667431 | Truhope.3 LLC | Nurse Practitioner | 10440 Little Patuxent Pkwy Ste 300, Columbia, MD 21044-3648 | 2018-01-25 |
| 1174038590 | Elizabeth Jane Eggebrecht | Nurse Practitioner | 2715 Colonial Dr Ste 100, Columbia, SC 29203-6818 | 2017-12-07 |
| 1639540420 | Stacy S Mallare | Nurse Practitioner | 10954 Hilltop Ln, Columbia, MD 21044-3780 | 2015-10-19 |
| 1790097913 | Ana C Duarte | Nurse Practitioner | 10632 Little Patuxent Pkwy Ste 410, Columbia, MD 21044-3252 | 2010-07-02 |
| 1437310471 | Ann Bowman Koons | Nurse Practitioner | 5500 Knoll North Dr., Suite 290, Joshi & Merchant, M.d., P.a., Columbia, MD 21045 | 2008-06-23 |
| Find all providers in COLUMBIA | ||||
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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.