IUDOK PREMOE (NPI# 1508915554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508915554 |
Entity Type | Individual |
Full Name | IUDOK PREMOE |
Credential | PNP |
Practice Address |
1050 W Perimeter Rd Pediatric Clinic Andrews Afb MD 20762-6601 |
Mailing Address |
1058 West Perimeter Road Pediatric Clinic Andrews Afb MD 20762 |
Practice Telephone | 2408572723 |
Practice Fax Number | 2408576263 |
Mailing Telephone | 2408572723 |
Mailing Fax Number | 2408576263 |
Enumeration Date | 2007-01-09 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R114085 | MD | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1050 W PERIMETER RD PEDIATRIC CLINIC |
City | ANDREWS AFB |
State | MD |
Zip Code | 20762-6601 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114360898 | Lori Lynn Littlejohn | Nurse Anesthetist, Certified Registered | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2013-04-11 |
1770838948 | Heidi Derade | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2012-07-13 |
1285916601 | Janet Denise Cochran | Social Worker | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2011-09-12 |
1699054288 | Jose Antonio Rodriguez | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2011-08-12 |
1497081574 | Lindsay Kate Gregus | Military Health Care Provider | 1050 W Perimeter Rd, Sgoic, Andrews Afb, MD 20762-6601 | 2009-10-26 |
1093049827 | Jon Burrill Geno | Nurse Practitioner | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-09-26 |
1740419084 | Christopher Clement Rhoney | Military Health Care Provider | 1050 W Perimeter Rd, 779 Mdg/sgn, Andrews Afb, MD 20762-6601 | 2009-07-08 |
1689800278 | Dexter Dewayne Robinson | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-06-09 |
1942444815 | Erica Marie Jasper | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-04-23 |
1760625040 | Teresa Rollins | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-04-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982210423 | Kevin Wang | Dentist | 1057 W Perimeter Rd, Prince County, MD 20762 | 2020-09-21 |
1306467667 | Priscilla Andalia | Student in an Organized Health Care Education/Training Program | 1065 W. Perimeter Road, Jb Andrews, MD 20762 | 2020-04-28 |
1275162877 | Gabi Im | Dentist | 1065 W Perimeter Rd., Joint Base Andrews, Apo, AA 20762 | 2020-04-06 |
1083240139 | Shirley Ye | Student in an Organized Health Care Education/Training Program | 1025 Boston Rd, Joint Base Andrews, MD 20762 | 2020-03-20 |
1255988853 | Songxuan Zhou Niemtzow | Acupuncturist | Acupuncture Center and Integrative Medicine Center, 1060 West Perimeter Road, Joint Base Andrews, MD 20762 | 2019-08-20 |
1487010971 | Tracy Ellen Ambos | Social Worker | 5100 Fetcher Avenue, Joint Base Andrews, MD 20762 | 2016-01-13 |
1154718450 | Ryan Mason Kring | Emergency Medicine | Malcolm Grow Medical Clinics, 1060 W Perimeter Rd, Joint Base Andrews, MD 20762 | 2015-04-24 |
1518206044 | Jeremy Gallman | Veterinarian | 1781 Arnold Ave., Joint Base Andrews, MD 20762 | 2013-02-04 |
1043556418 | Kimberly Mccoy-singh | Physical Therapist | 1075 West Perimeter Rd., 779 Mdos/sgoy, Joint Base Andrews, MD 20762 | 2012-12-12 |
1417215799 | Alexander Rostam Kheradi | Emergency Medicine | 1050 West Perimeter Road, Joint Base Andrews, MD 20762 | 2012-04-24 |
Find all providers in zip 20762 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902405574 | Kylie White | Nurse Practitioner | 29595 Millstream Dr, Salisbury, MD 21804-2006 | 2020-10-23 |
1437764214 | Kelly Weaver | Nurse Practitioner | 11315 Pembroke Square, 110, Waldorf, MD 20603 | 2020-09-09 |
1003420282 | Mary Claire Perry | Nurse Practitioner | 737 W Lombard St Ste 314, Baltimore, MD 21201-1009 | 2020-09-03 |
1063022853 | Lauren Ranieri | Nurse Practitioner | 5301 Westbard Cir Ste 3, Bethesda, MD 20816-1463 | 2020-08-06 |
1841847209 | Brittany Nichole Frankel | Nurse Practitioner | 5870 Old Washington Rd, Sykesville, MD 21784-8622 | 2019-08-21 |
1912553595 | Kelsey Lynn Peifer | Nurse Practitioner | 6131 Baldridge Ter, Frederick, MD 21701-5858 | 2019-08-10 |
1841845351 | Advanced Practice Wellness, LLC | Nurse Practitioner | Washingtonian Blvd Ste 550, Gaithersburg, MD 20878 | 2019-08-02 |
1851946305 | Monica Patel | Nurse Practitioner | 3450 Old Washington Rd Ste 100, Waldorf, MD 20602-3249 | 2019-08-01 |
1922651082 | Deborah A Weber | Nurse Practitioner | 480 Lake Dr, Lusby, MD 20657-3260 | 2019-07-18 |
1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
Find all providers with the same taxonomy |
City | ANDREWS AFB |
Zip Code | 20762 |
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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.