KATHLEEN MARIE MCINNIS (NPI# 1003985342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003985342 |
| Entity Type | Individual |
| Full Name | KATHLEEN MARIE MCINNIS |
| Credential | NNP |
| Practice Address |
2200 Bergquist Dr Ste 1 Attn Credentials (cmc) Lackland A F B TX 78236-9908 |
| Mailing Address |
313 Windcrest Dr San Antonio TX 78239-2421 |
| Practice Telephone | 2102926679 |
| Mailing Telephone | 2106376335 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
253573 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871878231 | Kathleen Mcinnis | Physical Therapist | 1269 Main St, Concord, MA 01742-3099 | 2011-10-18 |
| Street Address |
2200 BERGQUIST DR STE 1 ATTN CREDENTIALS (CMC) |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467891366 | Samantha Luanne Guy | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-06-24 |
| 1427492545 | Oscar Escano | General Practice | 2200 Bergquist Dr Ste 1, 59 Mhs/sgowv1, Lackland A F B, TX 78236-9908 | 2013-04-19 |
| 1881935112 | J T Floyd | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-03-12 |
| 1144583352 | Cleann Toner | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-06-21 |
| 1417223561 | Nancy Vogelgesang | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-03-22 |
| 1295011641 | Stephen Garrett Ray | Nurse Practitioner | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-10-31 |
| 1396029559 | Daniel Sung Oh | Military Health Care Provider | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-10-06 |
| 1184919763 | Marley Cranford Smith | Case Manager/Care Coordinator | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-06-13 |
| 1770881633 | Jennifer B Gillespie | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-03-02 |
| 1972804540 | Nilofer N Pervez Arthur | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Air Force Base, Lackland A F B, TX 78236-9908 | 2010-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 363LN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528528817 | Kensey Duncan | Nurse Practitioner | 6431 Fannin St # 3.242, Houston, TX 77030-1501 | 2019-03-22 |
| 1750840286 | Jissel Odette Espinoza | Nurse Practitioner | 8710 N 29th Ln, Mcallen, TX 78504-5982 | 2019-03-14 |
| 1184183659 | Enedelia Reyna | Nurse Practitioner | 222 E Ridge Rd Ste 202, Mcallen, TX 78503-1251 | 2019-03-14 |
| 1134688757 | Nancy Elizabeth Lane | Nurse Practitioner | 6310 Eagle Creek Dr, Flower Mound, TX 75028-2464 | 2019-03-13 |
| 1043781701 | Lisa Vercellino Salazar | Nurse Practitioner | The Woman's Hospital of Texas, 7600 Fannin, Houston, TX 77054 | 2018-12-06 |
| 1043746324 | Maria V Gutierrez | Nurse Practitioner | 1694 Zamora Dr, Brownsville, TX 78526-1997 | 2017-05-05 |
| 1578003786 | Briana Donise Blackstock | Nurse Practitioner | 210 Longhorn Blvd, Wolfforth, TX 79382-5322 | 2017-03-07 |
| 1619413911 | Richard Dunn | Nurse Practitioner | 1129 Birch St, Hurst, TX 76053-4301 | 2017-01-10 |
| 1245781830 | Lisa Marie Elizalde | Nurse Practitioner | 902 S Loop 499 Apt N4, Harlingen, TX 78550-2522 | 2016-10-18 |
| 1972050540 | Daniel Renteria I | Nurse Practitioner | 3280 Joe Battle Blvd., El Paso, TX 79936 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND A F B |
| Zip Code | 78236 |
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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.