STACEY DIRKSEN (NPI# 1992191738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992191738 |
| Entity Type | Individual |
| Full Name | STACEY DIRKSEN |
| Practice Address |
701 E County Line Rd Suite 101 Greenwood IN 46143-1072 |
| Practice Telephone | 3178852860 |
| Practice Fax Number | 3178852869 |
| Mailing Telephone | 3178852860 |
| Mailing Fax Number | 3178852869 |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2016-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71005554A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201298260 | 05 |
| Street Address |
701 E COUNTY LINE RD SUITE 101 |
| City | GREENWOOD |
| State | IN |
| Zip Code | 46143-1072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679570956 | Andrew David Dick | Family Medicine | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1070 | 2005-07-01 |
| 1073044954 | Caitlin Elizabeth Luebcke | Nurse Practitioner | 701 E County Line Rd, #101, Greenwood, IN 46143-1072 | 2017-03-23 |
| 1043759319 | Hannah E Mason | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1070 | 2017-02-19 |
| 1750829230 | Altus Direct, LLC | Psychiatry & Neurology | 701 E County Line Rd, Suite 210, Greenwood, IN 46143-1072 | 2017-02-06 |
| 1205382801 | Gwendolyn Whitis | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2016-09-01 |
| 1215385174 | Erika Leigh Felt | Physician Assistant | 701 E County Line Rd, Suite 201, Greenwood, IN 46143-1072 | 2016-06-01 |
| 1124487145 | Rebecca E Pullyard | Registered Nurse | 701 E County Line Rd, Greenwood, IN 46143-1072 | 2016-02-18 |
| 1487013025 | Teena Nichole Mulholland | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2016-02-10 |
| 1821456765 | Juli Davette White | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2016-02-07 |
| 1083090021 | Kristen Mounce | Nurse Practitioner | 701 E County Line Rd, Suite 101, Greenwood, IN 46143-1072 | 2015-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395299 | Tiffany Smirat | Pharmacist | 882 S Sr 135, Greenwood, IN 46143 | 2020-10-27 |
| 1083250138 | Benajmin Thomas Nyboer | Pharmacist | 5961 North State Road 135, Kroger Pharmacy, Greenwood, IN 46143 | 2019-11-25 |
| 1609417260 | Orthopaedics-indianapolis, Inc | Orthopaedic Surgery | 1579 Olive Branch Parke Lane, Suite 130, Greenwood, IN 46143 | 2019-10-04 |
| 1194282525 | Homebased Mental Health Service | Case Management | 2244 Blossom Dr, Greenwood, IN 46143 | 2019-02-21 |
| 1710478078 | Anne E Packard | Pharmacist | 333 E County Line Rd # 101, Greenwood, IN 46143 | 2018-05-22 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1891246633 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 5961 N Sr 135, Greenwood, IN 46143 | 2016-10-17 |
| 1477919637 | Ourhealth Physicians Group, LLC | Clinic/Center | 1273 N Emerson Ave Ste H, Greenwood, IN 46143 | 2016-01-04 |
| 1003212655 | American Health Network of Indiana, LLC | Non-Pharmacy Dispensing Site | 2355 Endress Place St A, Healthy Measures Wellness Clinic, Greenwood, IN 46143 | 2014-11-10 |
| 1265831366 | Katie D'agosto | Counselor | 3000 S State Road 135 Ste 230, Greenwood, IN 46143 | 2014-08-14 |
| Find all providers in zip 46143 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093322505 | Amy Decker | Nurse Practitioner | 452 Macy Way, Greenwood, IN 46142-7483 | 2020-09-29 |
| 1417574252 | Amanda Rees | Nurse Practitioner | 432 S Emerson Ave Ste 320, Greenwood, IN 46143-1952 | 2020-06-27 |
| 1093330979 | Renee Francine Jones | Nurse Practitioner | 698 Oldfield Commons Dr, Greenwood, IN 46142 | 2020-06-16 |
| 1487287579 | Angela Williams | Nurse Practitioner | 224 Georgia Ave, Greenwood, SC 29646-4642 | 2020-02-17 |
| 1740831015 | Cynthia Louise Lambert | Nurse Practitioner | 21580 Stacey Ln, Greenwood, NE 68366-1776 | 2019-09-26 |
| 1124682315 | Jill Bell Shirley | Nurse Practitioner | 105 Vinecrest Ct Ste 1000, Greenwood, SC 29646-8031 | 2019-04-24 |
| 1609332840 | Donna Luckett | Nurse Practitioner | 210 Amanda Dr Apt 15b, Greenwood, MS 38930-3820 | 2019-02-12 |
| 1902385123 | Cassandra Leigh Cole | Nurse Practitioner | 701 E County Line Rd Ste 204, Greenwood, IN 46143-1071 | 2018-08-08 |
| 1033607924 | Ez Clinic Inc. | Nurse Practitioner | 494 S Emerson Ave Ste I, Greenwood, IN 46143 | 2018-04-25 |
| 1346747995 | Kelli Diane Clune | Nurse Practitioner | 115 E Alexander Ave, Greenwood, SC 29646 | 2018-04-10 |
| Find all providers in GREENWOOD | ||||
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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.