MICHELLE SUE DEHNE (NPI# 1962994707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962994707 |
| Entity Type | Individual |
| Full Name | MICHELLE SUE DEHNE |
| Practice Address |
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603-3168 |
| Practice Telephone | 3096768123 |
| Practice Fax Number | 3096768455 |
| Mailing Telephone | 3096249259 |
| Mailing Fax Number | 3096768455 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209017740 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
420 NE GLEN OAK AVE STE 401 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974597 | Timothy P Oconnor | Transplant Surgery | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 | 2005-10-05 |
| 1780060517 | Danae Smith | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2015-08-04 |
| 1568848497 | Sarah Adams | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2015-08-03 |
| 1225434772 | Tonya Moore | Registered Nurse | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2014-11-11 |
| 1497172399 | Jill Oberle | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2014-03-28 |
| 1629344064 | David Edward Houser | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2012-03-29 |
| 1538325477 | Raji Jacob | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2008-07-30 |
| 1669648309 | Muhammad Waqar Khattak | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 | 2008-05-02 |
| 1982816237 | Anu Vishwanath | Pediatrics | 420 Ne Glen Oak Ave Ste 401, Suite 401, Peoria, IL 61603-3168 | 2007-05-07 |
| 1124152707 | Alexander J. Alonso | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2007-03-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962034215 | Lia Doh | Nurse Practitioner | 8357 W Rosewood Ln, Peoria, AZ 85383-3869 | 2020-02-05 |
| 1285274027 | Chauntel M Nessmith | Nurse Practitioner | 7540 W Jenan Dr, Peoria, AZ 85345-1367 | 2020-01-09 |
| 1003450925 | Kimberly Ann Flores | Nurse Practitioner | 12118 W Avenida Del Rey, Peoria, AZ 85383-5819 | 2019-11-04 |
| 1821630666 | Leesa K Jost | Nurse Practitioner | 8914 N Prairie Pointe Rd, Peoria, IL 61615-1574 | 2019-10-14 |
| 1942842018 | Tamarra Lynn Subyantoro | Nurse Practitioner | 5114 N Glen Park Place Rd Ste 110, Peoria, IL 61614-4686 | 2019-10-10 |
| 1255981593 | Eunmee Hong | Nurse Practitioner | 21369 N 79th Dr, Peoria, AZ 85382-4453 | 2019-09-18 |
| 1295297737 | Tasha R Besser | Nurse Practitioner | 5114 N Glen Park Place Rd Ste 220, Peoria, IL 61614-4686 | 2019-04-03 |
| 1669936506 | Kristin Danielle Downs | Nurse Practitioner | 10408 N Centerway Dr, Peoria, IL 61615-1234 | 2019-01-24 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1538665609 | Tara Moore | Nurse Practitioner | 10408 N Centerway Dr Ste Cde, Peoria, IL 61615-1234 | 2018-04-05 |
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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.