DESTEMONA BOZHANI-MARTE (NPI# 1801493275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801493275 |
| Entity Type | Individual |
| Full Name | DESTEMONA BOZHANI-MARTE |
| Practice Address |
5804 Sw Bray Rd Clarksdale MO 64430-9176 |
| Practice Telephone | 8162622889 |
| Mailing Telephone | 8162622889 |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
2020031429 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5804 SW BRAY RD |
| City | CLARKSDALE |
| State | MO |
| Zip Code | 64430-9176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598309627 | Gloria Burton | Social Worker | 7550 Sw Taylor Rd, Clarksdale, MO 64430-8132 | 2019-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386265627 | Lillie Mae Lockett | Technician | 1025 Ritchie Ave, Clarksdale, MS 38614 | 2020-04-28 |
| 1598309627 | Gloria Burton | Social Worker | 7550 Sw Taylor Rd, Clarksdale, MO 64430-8132 | 2019-10-31 |
| 1225696917 | Timothy Hill | Social Worker | 1414 6th St # 14146th, Clarksdale, MS 38614-6046 | 2019-05-29 |
| 1891252805 | Alvin Clayton Dixon | Pharmacist | 1967 Hospital Dr Ste B, Clarksdale, MS 38614-7203 | 2019-02-26 |
| 1356823728 | Tes Transportation | Non-emergency Medical Transport (VAN) | 839 Pecan St, Clarksdale, MS 38614-3033 | 2018-09-03 |
| 1124505649 | Anna Jones | Nurse Practitioner | 619 S State St, Clarksdale, MS 38614-6319 | 2018-07-26 |
| 1760979876 | Rotonia Gates | Licensed Practical Nurse | 2139 8th St, Clarksdale, MS 38614-6207 | 2018-04-16 |
| 1700304151 | Kimberly Michelle Dye | Home Health | 1015 Sasse St, Clarksdale, MS 38614-7533 | 2017-09-06 |
| 1982138533 | Angelia Mcdowell | Nurse Practitioner | 1023 Vincent St, Clarksdale, MS 38614-4617 | 2017-04-19 |
| 1609312891 | Coahoma County School Base Clinic | Clinic/Center | 1535 Lee Dr, Clarksdale, MS 38614-2914 | 2017-01-11 |
| Find all providers in CLARKSDALE | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144785684 | Undra L Haggan | Nurse Practitioner | 1202 Desoto Ave, Clarksdale, MS 38614-6937 | 2019-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437760675 | Justin Lucas Sweetin | Nurse Practitioner | 7727 Weston Pl, Richmond Heights, MO 63117-2018 | 2020-08-12 |
| 1962043802 | Bonne Terre Healthcare Clinic, LLC | Nurse Practitioner | 11 S Division St Ste A, Bonne Terre, MO 63628-1701 | 2019-10-02 |
| 1720639354 | Anne Nicole Dailey | Nurse Practitioner | 2330 E Meyer Blvd Ste T411, Kansas City, MO 64132-1162 | 2019-09-25 |
| 1326694605 | Affirm Management and Consulting, LLC | Nurse Practitioner | 4728 S Campbell Ave Ste 128, Springfield, MO 65810-1715 | 2019-08-13 |
| 1588122311 | Meskerm Workiye Asfaw | Nurse Practitioner | 589 Vintage Grove Ct, Wildwood, MO 63038-2314 | 2019-03-11 |
| 1063983088 | Jenny Lynette Brown | Nurse Practitioner | 6912 Candlewick Way, Florissant, MO 63033-5113 | 2018-12-17 |
| 1992270011 | Andrew Joseph Gucciardo | Nurse Practitioner | 12348 Old Tesson Rd Ste 250, Saint Louis, MO 63128-2261 | 2018-10-04 |
| 1679065098 | Aaron Dewayne Gitthens | Nurse Practitioner | 898 Sw State Route O, Osborn, MO 64474-9762 | 2018-06-01 |
| 1548763121 | Jennifer Williams | Nurse Practitioner | 4618 Colima Ct, Saint Louis, MO 63128-2309 | 2018-03-09 |
| 1821597840 | Patricia Hee Huebner | Nurse Practitioner | 15450 S Outer 40 Rd, Chesterfield, MO 63017-2066 | 2018-02-05 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSDALE |
| Zip Code | 64430 |
Please comment or provide details below to improve the information on DESTEMONA BOZHANI-MARTE.
| 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.