TINA NGUYEN GANNUSCIO (NPI# 1669871901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669871901 |
| Entity Type | Individual |
| Full Name | TINA NGUYEN GANNUSCIO |
| Credential | PHARMD |
| Practice Address |
800 Ne Glen Oak Ave Peoria IL 61603-3255 |
| Mailing Address |
3216 W Birkshire Dr Peoria IL 61614-2305 |
| Practice Telephone | 3093080448 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2016-11-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051297880 | IL | Pharmacy Service Providers |
| Street Address |
800 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760582266 | John Whittington | Family Medicine | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2006-09-24 |
| 1619577657 | Natalie Ann Stephens | Nurse Practitioner | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2020-10-28 |
| 1073178786 | Nicholas Mueller Piening | Student in an Organized Health Care Education/Training Program | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2019-05-08 |
| 1114581204 | Sherri Lynn Alvarez | Physical Therapist | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2019-04-24 |
| 1720218415 | Illinois Pathologist Services, LLC | Pathology | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2009-07-16 |
| 1477671592 | Osf Healthcare System | General Acute Care Hospital | 800 Ne Glen Oak Ave, Peoria, IL 61603-3255 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245397 | Lynsey Perera | Pharmacist | 7610 N Orange Prairie Rd, Peoria, IL 61615-9324 | 2020-11-05 |
| 1699375683 | Christopher Wayne Sharp | Pharmacist | 8062 W Eva St, Peoria, AZ 85345-7197 | 2020-10-28 |
| 1760093413 | Andrea Stump | Pharmacist | 24865 N Lake Pleasant Pkwy, Peoria, AZ 85383-1280 | 2020-08-14 |
| 1154957926 | Bhumit Kalavadiya | Pharmacist | 8375 W Pontiac Dr, Peoria, AZ 85382-1412 | 2020-03-12 |
| 1386290518 | Taylor Naberhaus | Pharmacist | 13640 N Plaza Del Rio Blvd # 210, Peoria, AZ 85381-4846 | 2019-08-13 |
| 1043767106 | Jason Mcaddley | Pharmacist | 9425 West Union Hills Drive, Peoria, AZ 85382 | 2016-09-07 |
| 1801263579 | John Leano | Pharmacist | 26898 N 87th Dr, Peoria, AZ 85383 | 2015-08-28 |
| 1245638782 | Adam Browning | Pharmacist | 12456 W Milton Dr, Peoria, AZ 85383-5009 | 2014-12-16 |
| 1447664784 | Rusvel Villamarin Santacruz | Pharmacist | 9313 W Ross Ave, Peoria, AZ 85382-5237 | 2014-06-15 |
| 1811300684 | Edward Monroe | Pharmacist | 316 W Ridgemont Rd, Peoria, IL 61614-7222 | 2014-06-09 |
| 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.