JANIS D EBOLUM (NPI# 1710985072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710985072 |
Entity Type | Individual |
Full Name | JANIS D EBOLUM |
Credential | APRN-BC |
Practice Address |
140 Dover St Shelbyville TN 37160-2776 |
Practice Telephone | 9316843426 |
Practice Fax Number | 9316845860 |
Mailing Telephone | 9316843426 |
Mailing Fax Number | 9316845860 |
Enumeration Date | 2005-07-11 |
Last Update Date | 2012-07-14 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000005513 | TN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BCBS | 4057644 | 01 | |
TN | 3897887 | 05 |
Street Address |
140 DOVER ST |
City | SHELBYVILLE |
State | TN |
Zip Code | 37160-2776 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093353120 | Rebecca Fetters | Registered Nurse | 140 Dover St, Shelbyville, TN 37160-2776 | 2019-12-19 |
1619456803 | Miguel Angel Villegas | Dietitian, Registered | 140 Dover St, Shelbyville, TN 37160-2776 | 2018-08-09 |
1538647094 | Ashley Michelle Wiseman | Registered Nurse | 140 Dover St, Shelbyville, TN 37160-2776 | 2018-08-06 |
1902303886 | Laura Underwood | Registered Nurse | 140 Dover St, Shelbyville, TN 37160-2776 | 2018-04-09 |
1144744384 | Elena Ruth Quinonez | Public Health or Welfare | 140 Dover St, Shelbyville, TN 37160-2776 | 2017-07-31 |
1730637620 | Regina Holbert | Nurse's Aide | 140 Dover St, Shelbyville, TN 37160-2776 | 2016-09-20 |
1598212763 | Cathine Tidwell | Nurse's Aide | 140 Dover St, Shelbyville, TN 37160-2776 | 2016-09-06 |
1265988729 | Noemi Leon | Dietitian, Registered | 140 Dover St, Shelbyville, TN 37160-2776 | 2016-08-25 |
1992164560 | Lorrie Nugent | Registered Nurse | 140 Dover St, Shelbyville, TN 37160-2776 | 2016-02-11 |
1235523499 | Cassie Pollock | Licensed Practical Nurse | 140 Dover St, Shelbyville, TN 37160-2776 | 2015-03-26 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255821310 | Middle Tennessee Support Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 375 Uselton Road, Shelbyville, TN 37160 | 2018-05-15 |
1194224998 | Stephen Blake Feldhaus | Nurse Practitioner | 112 Airport Business Park Rd, Ste H, Shelbyville, TN 37160 | 2018-02-07 |
1285158519 | Angelique Lynn Oliver | Case Management | 604 S. Wall St., Shelbyville, TN 37160 | 2017-07-28 |
1215476445 | Acts of Kindness | Home Health | 213 Lane Parkway, Shelbyville, TN 37160 | 2017-02-21 |
1255727681 | Nancy Elizabeth Hudson | Counselor | 117 Mcgrew Street, Shelbyville, TN 37160 | 2015-04-13 |
1699177956 | Shelbyville Medical Group, Pllc | Family Medicine | 221 Lane Parkway, Shelbyville, TN 37160 | 2014-09-18 |
1154637122 | Digestive Healthcare of Central Tennessee, Pllc | Internal Medicine | 112 Airport Business Park Drive, Suite G, Shelbyville, TN 37160 | 2010-08-27 |
1871791293 | Frank L Jayakody Md PC | Family Medicine | 1701 North Main St, Shelbyville, TN 37160 | 2007-07-06 |
1871794222 | Glen Oaks, LLC | Skilled Nursing Facility | 1101 Glenoaks Rd, Shelbyville, TN 37160 | 2007-05-31 |
1346459385 | Chamberland Dentistry PC | Preferred Provider Organization | 1006 Colloredo Blvd, Shelbyville, TN 37160 | 2007-05-22 |
Find all providers in zip 37160 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568083038 | Lisa Marie Lee | Nurse Practitioner | 300 Northridge Dr, Shelbyville, IN 46176-8954 | 2020-05-06 |
1003475534 | Melissa Marie Pritchett | Nurse Practitioner | 768 Friesian Ct, Shelbyville, KY 40065-7211 | 2019-06-09 |
1508347154 | Kathryn Nicole Neisler | Nurse Practitioner | 2451 Intelliplex Dr Ste 210, Shelbyville, IN 46176-8581 | 2018-08-22 |
1649750167 | Mary Elizabeth Lamb | Nurse Practitioner | 80 Providence Rd, Shelbyville, TN 37160-4835 | 2018-08-14 |
1194224998 | Stephen Blake Feldhaus | Nurse Practitioner | 112 Airport Business Park Rd, Ste H, Shelbyville, TN 37160 | 2018-02-07 |
1174066013 | Katherine Washburn | Nurse Practitioner | 311 Boone Station Rd Lot, Shelbyville, KY 40065-8673 | 2016-11-27 |
1144777335 | Johanna Coursey | Nurse Practitioner | 6799 Frankfort Rd, Shelbyville, KY 40065-9495 | 2016-09-06 |
1104294776 | Right Care, Shelbyville, LLC | Nurse Practitioner | 1731 N Main St, Suite F, Shelbyville, TN 37160-2372 | 2015-09-12 |
1467863613 | Janell Chunn Williams | Nurse Practitioner | 120 Montgomery Rd, Shelbyville, TN 37160-6258 | 2014-05-09 |
1013332329 | Nikki Michelle Turner | Nurse Practitioner | 208 Lane Pkwy, Shelbyville, TN 37160-3109 | 2014-02-24 |
Find all providers in SHELBYVILLE |
City | SHELBYVILLE |
Zip Code | 37160 |
Please comment or provide details below to improve the information on JANIS D EBOLUM.
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.