GWENDOLYN CHAMPION (NPI# 1407241300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407241300 |
| Entity Type | Individual |
| Full Name | GWENDOLYN CHAMPION |
| Other Name | GWENDOLYN SCOTT |
| Credential | LSA |
| Practice Address |
4026 E Teal Estates Cir Fresno TX 77545 |
| Mailing Address |
4026 E Teal Estates Cir Fresno TX 77545-8851 |
| Practice Telephone | 5109848610 |
| Mailing Telephone | 5109848610 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-04-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
SA00547 | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4026 E TEAL ESTATES CIR |
| City | FRESNO |
| State | TX |
| Zip Code | 77545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376901843 | Phenomsurgical Assisting | Specialist/Technologist, Other | 4026 E Teal Estates Cir, Fresno, TX 77545-8851 | 2016-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780100610 | Schristiandevelopment | Day Training, Developmentally Disabled Services | 3819 Teal Maple Ct., Fresno, TX 77545 | 2017-08-22 |
| 1548786924 | Katreece M Bell | Nurse Practitioner | 1834 Bravos Manor Lane, Fresno, TX 77545 | 2017-08-17 |
| 1275912735 | Evosource | Non-emergency Medical Transport (VAN) | 1307 Peacham Ct, Fresno, TX 77545 | 2015-05-29 |
| 1811394745 | Elaine Khuong | Pharmacist | 12225 Sr 6, Fresno, TX 77545 | 2014-11-20 |
| 1225442551 | Michael Jerome Tubbs | Specialist/Technologist, Other | 2126 Beacon Light Ln, Fresno, TX 77545 | 2014-06-14 |
| 1801219431 | Angelica Healthcare Services | Home Health | 3003 Valian Elm Street, Fresno, TX 77545 | 2014-02-03 |
| 1801048376 | Kroger Texas L P | Pharmacy | 10250 Fresno State Hwy 6, Fresno, TX 77545 | 2008-10-16 |
| 1215188818 | Kroger Texas Lp | Pharmacy | 10250 State Hwy 6, Fresno, CA 77545 | 2008-10-02 |
| 1528243201 | M & H Home Care Inc. | Home Health | 1335 Hunter Green Lane, Fresno, TX 77545 | 2007-12-31 |
| 1275628786 | Melissa Kaye Earls | Counselor | 4502 Reams Ln, Fresno, TX 77545 | 2006-10-03 |
| Find all providers in zip 77545 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043720741 | Luis Rodriguez Gonzalez | Physician Assistant | 4730 Brazos Point Ln, Fresno, TX 77545-7968 | 2017-10-07 |
| 1740326891 | Michael J Sinopoli | Physician Assistant | 4910 E Clinton Way Ste 101, Fresno, CA 93727-1560 | 2007-01-29 |
| 1881212397 | Veshudha Kang | Physician Assistant | 2615 E Clinton Ave, Fresno, CA 93703-2223 | 2020-07-10 |
| 1154941011 | Kylie Wermund | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-04-21 |
| 1326604216 | Kelsey Tallman | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2019-05-15 |
| 1306402532 | Justin Frances Gagnon | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2019-05-13 |
| 1821532292 | Tran Luong | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2016-12-05 |
| 1487003414 | Maribel Manriquez | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2016-06-09 |
| 1558739052 | Kathryn L. Hanks | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2015-09-14 |
| 1407242456 | Zhijian Wang | Physician Assistant | 45 E River Park Pl W, Suite 104, Fresno, CA 93720-1562 | 2015-04-07 |
| Find all providers in FRESNO | ||||
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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.