MRS. JEAN M KANIDIS (NPI# 1639353410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639353410 |
| Entity Type | Individual |
| Full Name | MRS. JEAN M KANIDIS |
| Credential | APRN |
| Practice Address |
1033 N Parkway Frontage Rd Lakeland FL 33803-0401 |
| Mailing Address |
1600 Lakeland Hills Blvd Lakeland FL 33805-3019 |
| Practice Telephone | 8636807190 |
| Practice Fax Number | 8662648519 |
| Mailing Telephone | 8636807000 |
| Mailing Fax Number | 8662648519 |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APRN9307005 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | F1207029 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9307005 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1033 N PARKWAY FRONTAGE RD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-0401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932107158 | Tamara Threlkeld Pistoria | Pediatrics | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2005-07-12 |
| 1811432461 | Emily Beriswill | Nurse Practitioner | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2017-01-05 |
| 1497137780 | Erica Ford | Nurse Practitioner | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2015-06-23 |
| 1992104152 | Laura Dixon | Nurse Practitioner | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2014-08-13 |
| 1396169132 | Georgette Farmer | Nurse Practitioner | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2014-02-14 |
| 1811139215 | Jarett Aldon Gregory | Internal Medicine | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2009-03-31 |
| 1437348497 | Catherine Browning Marcum | Dermatology | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2007-10-16 |
| 1124166574 | Watson Clinic LLP | Allergy & Immunology | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2007-02-01 |
| 1902969074 | Allan G Wells | Emergency Medicine | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2006-12-19 |
| 1477576478 | Brett J Widick | Family Medicine | 1033 N Parkway Frontage Rd, Lakeland, FL 33803-0401 | 2006-07-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629686845 | Robert Salzman | Nurse Practitioner | 1328 Jaffa St, Lakeland, FL 33801-5706 | 2020-07-14 |
| 1578180493 | Kristen Kay Crumpton | Nurse Practitioner | 615 Midflorida Dr Ste 1, Lakeland, FL 33813-4921 | 2020-06-26 |
| 1053958694 | Cathy Lorraine Molina | Nurse Practitioner | 6063 Sunset Vista Dr, Lakeland, FL 33812-4441 | 2019-12-02 |
| 1003452418 | Cheza Marie Wilkinson | Nurse Practitioner | 2849 Jennifer Dr, Lakeland, FL 33810-5107 | 2019-11-20 |
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1154988210 | Doreen Opal Lue | Nurse Practitioner | 6855 Ashbury Dr, Lakeland, FL 33809-7818 | 2019-05-23 |
| 1962068155 | Lindsey Silas Escobar | Nurse Practitioner | 1490 Town Center Dr, Lakeland, FL 33803-7965 | 2019-05-14 |
| 1134695547 | Misti Dawn Thomas | Nurse Practitioner | 1737 Sherwood Lakes Blvd, Lakeland, FL 33809-6809 | 2018-10-23 |
| 1891260725 | Benito Angelo Rodriguez | Nurse Practitioner | 2417 Us Highway 98 N # 512, Lakeland, FL 33805-2410 | 2018-10-08 |
| 1255833513 | Justin Ross Hooper | Nurse Practitioner | 1285 Vista Hills Dr, Lakeland, FL 33813-5642 | 2018-03-02 |
| Find all providers in LAKELAND | ||||
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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.