IRYNA CRIBLEY (NPI# 1508139023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508139023 |
| Entity Type | Individual |
| Full Name | IRYNA CRIBLEY |
| Other Name | IRYNA KYZYMYSHYN |
| Credential | CRNP |
| Practice Address |
400 Teegarden St La Porte IN 46350-3175 |
| Practice Telephone | 2193260043 |
| Practice Fax Number | 2193268909 |
| Mailing Telephone | 2193260043 |
| Mailing Fax Number | 2193268909 |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2020-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71007715A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
28239908A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
COA.18108-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP011970 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE PTAN | IN2920087 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 38429 Lake Shore Blvd, Suite 103, Willoughby, OH 440947009 | 4409469200 |
| Street Address |
400 TEEGARDEN ST |
| City | LA PORTE |
| State | IN |
| Zip Code | 46350-3175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891838629 | Susan K Grace | Nurse Practitioner | 400 Teegarden St, Suite B, La Porte, IN 46350-3175 | 2007-02-14 |
| 1447808076 | Denise Doris Grasser | Social Worker | 400 Teegarden St, La Porte, IN 46350-3175 | 2019-08-27 |
| 1538728399 | Healthlinc, Inc | Clinic/Center | 400 Teegarden St, La Porte, IN 46350-3175 | 2019-06-06 |
| 1588051726 | Alexis Dunlap | Nurse Practitioner | 400 Teegarden St, La Porte, IN 46350-3175 | 2015-04-24 |
| 1124456926 | Manogna Katakam | Dentist | 400 Teegarden St, La Porte, IN 46350-3175 | 2013-10-15 |
| 1194077644 | Wendy Renee Dutcher | Registered Nurse | 400 Teegarden St, La Porte, IN 46350-3175 | 2012-10-09 |
| 1003122474 | Benjamin Lloyd Porter | Dentist | 400 Teegarden St, La Porte, IN 46350-3175 | 2010-08-24 |
| 1386880060 | Indiana University Health La Porte Hospital Inc | Clinic/Center | 400 Teegarden St, La Porte, IN 46350-3175 | 2008-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871139246 | Carolyn Ann Perra | Pharmacist | 55 Pine Lake S.c., Laporte, IN 46350 | 2019-11-20 |
| 1306496492 | Trinity Healthcare Inc. | Occupational Therapist | 2002 Andrew Avenue, Laporte, IN 46350 | 2019-09-19 |
| 1184136665 | Diane Margaret Rich | Physical Therapist | 1643 S Willow Bend Dr, La Porte, IN 46350 | 2017-10-24 |
| 1114460102 | Judith Marie Fitzhugh | Dietitian, Registered | 1775 S. Basswood Trail, Laporte, IN 46350 | 2016-11-23 |
| 1568916971 | Total Renal Care, Inc. | Clinic/Center | 1406 E Lincolnway, Ste A, La Porte, IN 46350 | 2016-08-15 |
| 1083079008 | Irene Torres | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350 | 2015-12-17 |
| 1124422910 | Becky Alwood-wallace | Occupational Therapist | 1203 Washington Street, Iu Health La Porte Hospital Wellness & Rehabilitation, La Porte, IN 46350 | 2014-10-22 |
| 1881001527 | Johnson Memorial Hospital | Skilled Nursing Facility | 3530 Monroe Street, La Porte, IN 46350 | 2014-07-15 |
| 1306268941 | Tiffany Anne Satterfield | Physical Therapy Assistant | 194 S 400 E, Laporte, IN 46350 | 2014-01-16 |
| 1801122239 | Mary Barbara Backer | Internal Medicine | 301 Willow Bend Dr, La Porte, IN 46350 | 2009-10-20 |
| Find all providers in zip 46350 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710594767 | Brooklynn Smock | Nurse Practitioner | 309 W Johnson Rd, La Porte, IN 46350-1982 | 2020-09-24 |
| 1518575182 | Joanne Lacoste | Nurse Practitioner | 931 Myrtle Creek Dr, La Porte, TX 77571-2767 | 2020-07-20 |
| 1922634542 | Raymond Joseph Keener | Nurse Practitioner | 711 W 250 S, La Porte, IN 46350-8108 | 2020-03-15 |
| 1174050603 | Agnes U Ololo | Nurse Practitioner | 3802 Stuart Dr, La Porte, TX 77571-3942 | 2017-05-15 |
| 1750823795 | Tiffany Bowen | Nurse Practitioner | 508 Legacy Plz W, La Porte, IN 46350-5254 | 2016-11-08 |
| 1407159155 | Jocelyn Leigh Stowell | Nurse Practitioner | 311 Boyd Blvd., La Porte, IN 46350-3965 | 2010-12-17 |
| 1891838629 | Susan K Grace | Nurse Practitioner | 400 Teegarden St, Suite B, La Porte, IN 46350-3175 | 2007-02-14 |
| 1083228399 | April Donald | Nurse Practitioner | 204 Legacy Plz W, La Porte, IN 46350-5285 | 2020-09-03 |
| 1033748736 | Tami Clinkenbeard | Nurse Practitioner | 401 Newporte Blvd, La Porte, IN 46350-4099 | 2020-04-04 |
| 1255963336 | Brittany L. Catizone | Nurse Practitioner | 1407 Lincolnway, La Porte, IN 46350-3105 | 2020-02-06 |
| Find all providers in LA PORTE | ||||
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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.