MRS. LISSA J DIEFENDORF (NPI# 1427356336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427356336 |
Entity Type | Individual |
Full Name | MRS. LISSA J DIEFENDORF |
Credential | APN |
Practice Address |
403 W Corrington Ave Peoria IL 61604-2803 |
Practice Telephone | 3092225736 |
Mailing Telephone | 3092225736 |
Enumeration Date | 2011-03-02 |
Last Update Date | 2011-03-02 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
209008169 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
403 W CORRINGTON AVE |
City | PEORIA |
State | IL |
Zip Code | 61604-2803 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205357928 | Nydia I Rodriguez | Nurse's Aide | 3305 N Finnell Ave, Peoria, IL 61604 | 2017-07-03 |
1720327976 | Brin Diagnostics Inc. | Clinical Medical Laboratory | 3216 W Kenwood, West Peoria, IL 61604 | 2013-02-07 |
1225373715 | Ngocyen Thi Ngo | Pharmacist | 2515 N Knoxville Avenue, Peoria, IL 61604 | 2012-12-10 |
1194027003 | Schelly Chiropractic, Inc | Chiropractor | 1208 W Loucks, Peoria, IL 61604 | 2010-11-29 |
1770755852 | Dental Sealants & More | Dentist | 2126 N. University St., Peoria, IL 61604 | 2008-03-28 |
1821266123 | David L Krick | Dentist | 2022 N University, Peoria, IL 61604 | 2008-02-20 |
1568658409 | Advanced Physicians Health Care, S.c. | Chiropractor | 1200 West Loucks Ave, Peoria, IL 61604 | 2007-09-24 |
1902006000 | Noel Liu | Dentist | 3127 N. University St., Unit C, Peoria, IL 61604 | 2007-07-18 |
1568586386 | Susan B Bordenave-bishop | Dentist | 2116 N. Sheridan, Peoria, IL 61604 | 2007-03-19 |
1174689897 | Paul Anthony Amodeo | Dentist | 3100 N Dries Lane, Suite 301, Peoria, IL 61604 | 2006-12-28 |
Find all providers in zip 61604 |
Taxonomy Code | 364SA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528351962 | Kristi Kae Williams | Clinical Nurse Specialist | 530 Ne Glenoak Avenue Pob Suite 108, Peoria, IL 61603-3117 | 2011-05-18 |
1356792956 | Jessica Gamblin | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2016-06-24 |
1285045013 | Melinda Lucille Lange | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-05-14 |
1679904858 | William Meyers II | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-12-12 |
1609211101 | Ruth Ann Arms | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-1726 | 2013-05-09 |
1902152077 | Linda Marie Cooper | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-07-26 |
1871865683 | Sarah L Lindsey | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2012-02-09 |
1104103670 | Jessica M Stewart | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2011-11-10 |
1124304407 | Melissa R Mcqueary | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2011-10-31 |
1598048456 | Laura A Youngman | Clinical Nurse Specialist | 2265 W Altorfer Dr, Peoria, IL 61615-1807 | 2011-09-27 |
Find all providers in PEORIA |
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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.