MITZI GAIL PEMBERTON (NPI# 1366717134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366717134 |
| Entity Type | Individual |
| Full Name | MITZI GAIL PEMBERTON |
| Credential | LPN |
| Practice Address |
1500 N 6th St Ponca City OK 74601-2827 |
| Mailing Address |
3003 Turner St Apt B Ponca City OK 74604-1537 |
| Practice Telephone | 5807630931 |
| Practice Fax Number | 5807630934 |
| Mailing Telephone | 5807637171 |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | L0045857 | OK | Nursing Service Providers |
| Street Address |
1500 N 6TH ST |
| City | PONCA CITY |
| State | OK |
| Zip Code | 74601-2827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730130170 | Geoffrey H. Cowan | Counselor | 1500 N 6th St, Ponca City, OK 74601-2827 | 2006-05-12 |
| 1447812029 | Creoks Behavioral Health Services | Clinic/Center | 1500 N 6th St, Ponca City, OK 74601-2827 | 2019-07-03 |
| 1033689005 | Renia Lynn Batman | Counselor | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-12-03 |
| 1326531815 | Jeremy Jones | Social Worker | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-06-11 |
| 1962993162 | Krystal Jane Lawson | Case Manager/Care Coordinator | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-05-23 |
| 1306343546 | Jeanine Vest | Counselor | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-04-12 |
| 1891295911 | Chandra Kimble | Social Worker | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-02-15 |
| 1598265605 | Jenny Rae Kizziar | Case Manager/Care Coordinator | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-02-15 |
| 1164921730 | Jamie Lee Dunster | Case Manager/Care Coordinator | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-02-08 |
| 1003324021 | Jennifer Lyn Johnson | Case Manager/Care Coordinator | 1500 N 6th St, Ponca City, OK 74601-2827 | 2018-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245867258 | Triad Health Systems LLC | Family Medicine | 2703 N 14th St, Ponca City, OK 74601 | 2020-03-27 |
| 1679096952 | Gabrielle Evangeline Barnes | Case Manager/Care Coordinator | 620 W. Grand, Ponca City, OK 74601 | 2017-07-19 |
| 1942722889 | Kimbra Leigh Anderson | Case Manager/Care Coordinator | 1500 N. 6th, Ponca City, OK 74601 | 2017-07-12 |
| 1033631965 | Kayla Patten | Case Manager/Care Coordinator | 620 W Grand, Ponca, OK 74601 | 2017-07-12 |
| 1639601859 | Affordable Dental | Dentist | 1618 N 5th St Ste 4, Ponca City, OK 74601 | 2017-03-28 |
| 1447627237 | Harold Jason Laughlin Jr. | Chiropractor | 222 E. Grand, Ste. 309, Ponca City, OK 74601 | 2015-08-27 |
| 1578947875 | Jessica James | Social Worker | 1500 N 6th, Ponca City, OK 74601 | 2015-07-16 |
| 1639565153 | Ryian Reyes | Point of Service | 2101 N 14th, Suite 134, Ponca City, OK 74601 | 2015-04-10 |
| 1003253006 | Proving Faithful Investments Inc. | Home Health | 205 W. Hartford Avenue #112, Ponca City, OK 74601 | 2013-05-30 |
| 1427365899 | Quint Allen Whitefield | Dentist | 1618 N. 5th Street, Suite #2, Ponca City, OK 74601 | 2010-09-08 |
| Find all providers in zip 74601 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184010373 | Scott Layton | Licensed Practical Nurse | 1116 Brentwood Dr, Ponca City, OK 74601-1711 | 2015-04-14 |
| 1376816645 | Claudia Jo Dilbeck | Licensed Practical Nurse | 11 Spring Vlg, Ponca City, OK 74604-5135 | 2012-02-17 |
| 1992940662 | Ana Maria Soledad Pando | Licensed Practical Nurse | 8 Forest Rd, Ponca City, OK 74604-5119 | 2008-12-10 |
| 1003062423 | Jackie Sue Tarr | Licensed Practical Nurse | 1417 Mcgraw Dr, Ponca City, OK 74601-2948 | 2008-08-18 |
| 1861092462 | Paige Marie Cordova | Licensed Practical Nurse | 13 Hillcrest Dr, Ponca City, OK 74604-4808 | 2020-11-01 |
| 1609276914 | Sandy Brown | Licensed Practical Nurse | 1500 N 6th St, Ponca City, OK 74601-2827 | 2014-08-25 |
| 1194060137 | Beverly F. Brown | Licensed Practical Nurse | 200 White Eagle Dr, Ponca City, OK 74601-8315 | 2012-12-03 |
| 1780998526 | Tammy Louise Allison | Licensed Practical Nurse | 200 White Eagle Drive, Ponca City, OK 74601 | 2010-08-04 |
| 1063684082 | Anna Mckinnis Beard | Licensed Practical Nurse | 200 White Eagle Dr, Ponca City, OK 74601 | 2008-03-31 |
| 1831314632 | Victoria A Brown | Licensed Practical Nurse | 200 White Eagle Dr, Ponca City, OK 74601 | 2007-04-16 |
| Find all providers in PONCA CITY | ||||
| City | PONCA CITY |
| Zip Code | 74601 |
Please comment or provide details below to improve the information on MITZI GAIL PEMBERTON.
| 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.