SUSAN E. KENNEL (NPI# 1942436092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942436092 |
| Entity Type | Individual |
| Full Name | SUSAN E. KENNEL |
| Credential | ARNP |
| Practice Address |
12901 Bruce B Downs Blvd Tampa FL 33612-4742 |
| Mailing Address |
Po Box 917770 Orlando FL 32891-7770 |
| Practice Telephone | 8139742201 |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2009-11-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
ARNP9271737 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001189900 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | Y00F8 | 01 |
| Street Address |
12901 BRUCE B DOWNS BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629076799 | Gonzalo Mantilla | Pediatrics | 12901 Bruce B Downs Blvd, Mdc 15, Tampa, FL 33612-4742 | 2005-07-12 |
| 1538796784 | Samia Valeria Ozorio Dutra | Registered Nurse | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-26 |
| 1255966289 | Jessica Huang | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2020-03-10 |
| 1487218764 | Chelsea Gebs Black | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612-4742 | 2019-04-23 |
| 1609430925 | Kathryn Elizabeth Rudibaugh | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-23 |
| 1467015883 | Thomas Cole | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-04-22 |
| 1417510751 | Kelly Powell | Physician Assistant | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-22 |
| 1700347283 | Kristopher Johnson | Nurse Practitioner | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2019-03-27 |
| 1366909129 | Derrik Jose Diaz Navarro | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4742 | 2019-02-27 |
| 1346717717 | Kyle William Woodward | Specialist/Technologist | 12901 Bruce B Downs Blvd, Tampa, FL 33612-4799 | 2018-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467083352 | Brittany Ann Parmenter | Nurse Practitioner | 4446 E Fletcher Ave Ste A, Tampa, FL 33613-4942 | 2020-01-29 |
| 1316505217 | Kelsey Anne Overton | Nurse Practitioner | 4444 E Fletcher Ave Ste B, Tampa, FL 33613-4905 | 2019-06-05 |
| 1881196798 | Jennifer March Santana | Nurse Practitioner | 3603 W Royal Palm Cir, Tampa, FL 33629-8353 | 2018-03-06 |
| 1083060636 | Dalia Azuolaityte Galley | Nurse Practitioner | 3838 W Neptune St Ste D6, Tampa, FL 33629-5841 | 2016-05-12 |
| 1275916165 | Sean M Wilder | Nurse Practitioner | 1919 W Swann Ave Fl 2, Tampa, FL 33606-2417 | 2015-07-09 |
| 1710372107 | Patsy Giarda | Nurse Practitioner | 3405 W Fletcher Ave, Tampa, FL 33618-2813 | 2015-04-01 |
| 1902297963 | Aimee Januska | Nurse Practitioner | 3003 W. Mlk Blvd, Mab 3rd Fl., Tampa, FL 33607 | 2015-02-12 |
| 1801239256 | Lindsey Sawicki | Nurse Practitioner | 4714 N Armenia Ave Ste 201, Tampa, FL 33603-2603 | 2013-04-15 |
| 1164766002 | Jose R. Foradada, IIi, Md, P.a. | Nurse Practitioner | 4710 N. Habana Ave., Suite 307, Tampa, FL 33614-7151 | 2012-11-15 |
| 1588938989 | Elena Marie Walker | Nurse Practitioner | 6216 E Sligh Ave, Tampa, FL 33617-9105 | 2012-03-02 |
| 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.