SAMANTHA NIKOLE GUDMUNSON (NPI# 1619590981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619590981 |
Entity Type | Individual |
Full Name | SAMANTHA NIKOLE GUDMUNSON |
Credential | RN |
Practice Address |
12 Health Services Dr Dekalb IL 60115-9637 |
Practice Telephone | 8157564875 |
Mailing Telephone | 8157564875 |
Enumeration Date | 2020-05-21 |
Last Update Date | 2020-05-21 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
041.411473 | IL | Nursing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 474579189001 | 05 |
Street Address |
12 HEALTH SERVICES DR |
City | DEKALB |
State | IL |
Zip Code | 60115-9637 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144393497 | Amylynn M Weiten | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2006-11-16 |
1952900375 | Brianna Rae Johnson | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-10-19 |
1215543111 | Rhyann Brianna Locke | Social Worker | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-09-17 |
1952925182 | Mariah Anne Thompson | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-06-03 |
1376167734 | Hannah Grace Brennan | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-06-02 |
1992326151 | Dianna Huttunen | Case Management | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-04-29 |
1558982702 | Kathleen C Wilkerson | Case Management | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-04-29 |
1457983108 | Andrew Ryan Phillips | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2020-02-11 |
1225670219 | Bonn Christian Cruz | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2019-10-11 |
1396394649 | Jennifer Lauren Larsen | Social Worker | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2019-09-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
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Taxonomy Code | 163WP0808X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265921415 | Rebecca Sue Tejumola | Registered Nurse | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2018-05-03 |
1114168630 | Michelle Talley | Registered Nurse | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2009-03-12 |
1194898478 | Mary Lemaster | Registered Nurse | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2006-11-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770101420 | Alissa Nichole Thompson | Registered Nurse | 2541 W Belden Ave Apt 1, Chicago, IL 60647-0482 | 2020-07-09 |
1548892565 | Sonja K Negrean | Registered Nurse | 280 Shuman Blvd, Naperville, IL 60563-8492 | 2020-02-07 |
1134772353 | Theresa Jane Debord | Registered Nurse | 5835 State Route 154 # Address2, Pinckneyville, IL 62274-3418 | 2019-07-17 |
1740740653 | Cherise C Rosen | Registered Nurse | 110 Frank Lloyd Wright Ln, Oak Park, IL 60302-2616 | 2019-03-25 |
1821589706 | Virginie Nyancho | Registered Nurse | 1336 Court Leona, Hanover Park, IL 60133-5419 | 2018-05-25 |
1861848681 | Merry Carlson | Registered Nurse | 1120 N Farnsworth Ave Apt 1d, Aurora, IL 60505-2049 | 2016-05-11 |
1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
1215360763 | Debra A Foppe | Registered Nurse | 19125 State Route 127, Carlyle, IL 62231-5303 | 2013-08-19 |
1871817742 | Bente Clausen | Registered Nurse | 715 Lake St Ste 720, Oak Park, IL 60301-1416 | 2010-03-22 |
1477887032 | Susan Leann Lear | Registered Nurse | 1001 N Market St Ste 101, Mount Carmel, IL 62863-1945 | 2009-09-29 |
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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.