MS. MARY MIRANDA WILLIS (NPI# 1700185964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700185964 |
| Entity Type | Individual |
| Full Name | MS. MARY MIRANDA WILLIS |
| Credential | LPN |
| Practice Address |
303 Rellim Dr Kent OH 44240-4531 |
| Practice Telephone | 3304312905 |
| Mailing Telephone | 3304312905 |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2011-03-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PN131177 | OH | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677406 | Mary Grace Willis | Licensed Vocational Nurse | 232 County Road 2921, Alba, TX 75410-5830 | 2020-10-22 |
| 1477051449 | Mary E Willis | Nurse Practitioner | 10510 Jefferson Ave Ste E, Newport News, VA 23601-3102 | 2018-01-25 |
| 1417313263 | Mary Willis | Physical Therapy Assistant | 10077 Infinity Ln, Piqua, OH 45356-7512 | 2016-01-10 |
| 1083700652 | Mary Willis | Counselor | 4656 Brambleton Avenue, Roanoke, VA 24018 | 2006-10-04 |
| 1518504620 | Mary Judith Willis | Counselor | 3333 University Ave Se, Minneapolis, MN 55414-3325 | 2019-12-08 |
| 1831521269 | Mary Willis | Pharmacist | 3800 Se 22nd Ave, 04004/rds, Portland, OR 97202-2918 | 2013-08-08 |
| 1083992267 | Mary Kristine Willis | Physician Assistant | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2011-07-22 |
| 1811223324 | Mary Kay Willis | Specialist/Technologist | 1248 Austin Hwy, Suite 210, San Antonio, TX 78209-4821 | 2009-10-19 |
| 1710127626 | Mary E Willis | Dietitian, Registered | 15101 Glenwood Ave, Stanley, KS 66223-3154 | 2009-03-05 |
| 1346499241 | Mary E Willis | Clinic/Center | 550 Pope Ave, Fort Leavenworth, KS 66027-2332 | 2008-09-16 |
| Street Address |
303 RELLIM DR |
| City | KENT |
| State | OH |
| Zip Code | 44240-4531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201887 | Julia Repasky | Speech-Language Pathologist | 4170 Oh-43, Kent, OH 44240 | 2020-09-24 |
| 1811515000 | Natasha Loveridge | Speech-Language Pathologist | 1949 Oh-59, Suite 202, Kent, OH 44240 | 2020-07-14 |
| 1215569256 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 247 Tallmadge Rd., Kent, OH 44240 | 2020-02-07 |
| 1710526702 | Rebecca K Cibik | Pediatrics | 2497 State Route 59, Kent, OH 44240 | 2019-12-23 |
| 1073099834 | Sean Joseph Hiemstra | Case Manager/Care Coordinator | 5982 Rhodes Road Kent Ohio 44240, Kent, OH 44240 | 2018-07-16 |
| 1740798081 | Mason Brain Yoder | Counselor | 1025 Erin Drive, Kent, OH 44240 | 2018-01-22 |
| 1710405055 | Ashley Barczok | Nurse Practitioner | 5982 Rhodes Road, Kent, OH 44240 | 2017-09-07 |
| 1073963930 | Kimberly Ruth Griffith | Counselor | 190 Currie Hall Pkwy Ste A, Kent, OH 44240 | 2016-06-21 |
| 1801257456 | Ra'mone Williams | Audiologist | 717 Beryl Dr, Kent, OH 44240 | 2016-03-10 |
| 1730546615 | Christina Cole | Nurse Practitioner | 1675 E Main St Ste 328, Kent, OH 44240 | 2016-01-22 |
| Find all providers in zip 44240 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857485 | Serah Wanjiru Njoroge | Licensed Practical Nurse | 14109 Se 282nd St, Kent, WA 98042-3916 | 2019-12-04 |
| 1366092785 | Kennly M Renicker | Licensed Practical Nurse | 709 Allerton St, Kent, OH 44240-4501 | 2019-09-17 |
| 1104483684 | Christian Rice | Licensed Practical Nurse | 478 Brentwood Ave, Kent, OH 44240-3236 | 2019-05-21 |
| 1396247409 | Jaid Monique Jackson | Licensed Practical Nurse | 902 Summit Gardens Blvd, Kent, OH 44240-7736 | 2018-03-05 |
| 1346792934 | Ngoc Tran | Licensed Practical Nurse | 24323 100th Pl Se, Kent, WA 98030-4841 | 2016-10-29 |
| 1386092054 | Amninder Ripsy Nagra-kaur | Licensed Practical Nurse | 10016 Se 218th Pl, Kent, WA 98031 | 2016-06-02 |
| 1104281526 | Kimberly Destefano | Licensed Practical Nurse | 27446 151st Pl Se, Kent, WA 98042 | 2015-12-30 |
| 1609248319 | Laura Beth Brumfield | Licensed Practical Nurse | 343 W Elm St, Kent, OH 44240-3715 | 2015-10-21 |
| 1104211259 | Octavia Lawler | Licensed Practical Nurse | 782 Silver Meadows Blvd Apt 202, Kent, OH 44240-1964 | 2015-04-04 |
| 1154726289 | Laura Michelle Alhassan | Licensed Practical Nurse | 3534 Duffield Rd., Kent, OH 44240 | 2014-10-31 |
| Find all providers in KENT | ||||
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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.