KATHLEEN LICKFELDT (NPI# 1821457870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821457870 |
| Entity Type | Individual |
| Full Name | KATHLEEN LICKFELDT |
| Credential | NP-C |
| Practice Address |
3010 E 138th Ave Ste 12 Tampa FL 33613 |
| Mailing Address |
11052 Ancient Futures Dr Tampa FL 33647-3575 |
| Practice Telephone | 8139752800 |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2019-04-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
9288359 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS | V68RY | 01 |
| FL | 025086800 | 05 |
| Street Address |
3010 E 138TH AVE STE 12 |
| City | TAMPA |
| State | FL |
| Zip Code | 33613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497759161 | Frank D Tagliarini Md Pa | Clinic/Center | 3010 E 138th Ave, Suite 100, Tampa, FL 33613-3904 | 2005-06-09 |
| 1750816054 | Rpa Healthcare LLC | Clinic/Center | 3010 E 138th Ave, Suite 7, Tampa, FL 33613-3904 | 2017-04-24 |
| 1003276361 | Courtney Pariso | Nurse Practitioner | 3010 E 138th Ave, Suite 12, Tampa, FL 33613-3904 | 2016-03-01 |
| 1629316625 | Roberta Anne Moore | Nurse Practitioner | 3010 E 138th Ave, Suite 12, Tampa, FL 33613-3904 | 2013-01-25 |
| 1699043828 | Deanna Davis | Dietitian, Registered | 3010 E 138th Ave, Suite 1, Tampa, FL 33613-3904 | 2011-12-02 |
| 1518133610 | Leon Wayne Mitchell Md Pa | Legal Medicine | 3010 E 138th Ave, Suite 100, Tampa, FL 33613-3904 | 2008-05-08 |
| 1053585596 | University Geriatric Center LLC | Legal Medicine | 3010 E 138th Ave, Suite 100, Tampa, FL 33613-3904 | 2008-04-16 |
| 1811177876 | Elizabeth Healy Marques | Nutritionist | 3010 E 138th Ave, Suite 12, Tampa, FL 33613-3904 | 2007-11-07 |
| 1790983203 | Victor Feliz De La Cruz | Internal Medicine | 3010 E 138th Ave, Suite 12, Tampa, FL 33613-3904 | 2007-07-05 |
| 1083774665 | Vasco M Marques Md Pa | Internal Medicine | 3010 E 138th Ave, Suite 12, Tampa, FL 33613-3904 | 2006-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877671 | Lisandra Isabelle Raba | Behavior Technician | 3299 Usf Banyan Circle, Tampa, FL 33613 | 2020-10-02 |
| 1184250490 | Stetho Md LLC | Family Medicine | 1707 E Bearss Ave, Tampa, FL 33613 | 2020-03-18 |
| 1174187645 | Renee Pinheiro | Student in an Organized Health Care Education/Training Program | Usf Health Morsani College of Medicine, 12901 Bruce B Downs Blvd. Mdc5, Tampa, FL 33613 | 2019-04-30 |
| 1104388842 | Heartbeat Home Health Care LLC | Home Health | 13542 N Florida Ave Ste 209-b, Tampa, FL 33613 | 2019-04-02 |
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1780170266 | Joy M. Alexander | Driver | 14209 Cyber Pl Apt 102, Tampa, FL 33613 | 2018-07-08 |
| 1598289829 | Lillian Perez | Social Worker | 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 | 2017-07-28 |
| 1134640386 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3100 E Fletcher Ave Ste A165, Tampa, FL 33613 | 2017-06-28 |
| 1770016099 | Marcus Bruno | Physician Assistant | 13701 Bruce B Downs Blvd., Tampa, FL 33613 | 2017-04-04 |
| Find all providers in zip 33613 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157669 | Lotaya Anneka Hinds | Nurse Practitioner | 2105 E 115th Ave, Tampa, FL 33612-6121 | 2020-09-03 |
| 1821608324 | Racquel Creus | Nurse Practitioner | 20530 Colonial Isle Dr Unit 202, Tampa, FL 33647-3701 | 2020-08-09 |
| 1295360717 | Geni Horne | Nurse Practitioner | 931 Balaye Ridge Cir Apt 301, Tampa, FL 33619-5093 | 2020-03-04 |
| 1669006748 | Andrea Barnett | Nurse Practitioner | 3133 W Villa Rosa St, Tampa, FL 33611-2943 | 2020-02-27 |
| 1679104566 | Chinwe Ifeyinwa Iloanya | Nurse Practitioner | 4603 River Hills Dr, Tampa, FL 33617-6921 | 2020-01-29 |
| 1598231789 | Christee Elan Bond | Nurse Practitioner | 4809 N Armenia Ave Ste 210, Tampa, FL 33603-1425 | 2018-10-16 |
| 1609378991 | Randolph Diabetes and Wellness LLC | Nurse Practitioner | 8017 Savannah Sunset Ln, Tampa, FL 33615-1388 | 2018-03-02 |
| 1912407628 | Jonathan D Pope | Nurse Practitioner | 2708 N 22nd St, Tampa, FL 33605-2760 | 2018-02-19 |
| 1639607732 | Jackie Dale Hatten Jr. | Nurse Practitioner | 500 N West Shore Blvd Ste 635, Tampa, FL 33609-1910 | 2017-06-01 |
| 1629519814 | Kristen Hanenian | Nurse Practitioner | 4905 W Laurel St, Suite 200, Tampa, FL 33607-3834 | 2017-03-20 |
| Find all providers in TAMPA | ||||
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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.