AMBER STAR WEDGE (NPI# 1013475771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013475771 |
| Entity Type | Individual |
| Full Name | AMBER STAR WEDGE |
| Credential | LPN |
| Practice Address |
3001 Warrior Ln Poplar Bluff MO 63901-8685 |
| Practice Telephone | 5736861200 |
| Mailing Telephone | 5736861200 |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 2015033100 | MO | Nursing Service Providers |
| Street Address |
3001 WARRIOR LN |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-8685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083638506 | Robin Denise Vickery | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2006-07-27 |
| 1235738493 | Family Counseling Center, Inc. | Clinic/Center | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-10-20 |
| 1972117620 | Selina Ann Mcklintic | Registered Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-09-01 |
| 1477163764 | Paula Kay Dawes | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-08-03 |
| 1275141921 | Matthew Owens | Behavior Technician | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-07-20 |
| 1730797564 | Holly Rebecca Carter | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-07-17 |
| 1174144547 | Angela Michelle Slaughter | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-27 |
| 1215558655 | Ashley Don Scheffler | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-27 |
| 1922628510 | Jennifer Lee Taylor | Behavior Technician | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-23 |
| 1639708233 | Zackary James Ladyman | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043849672 | Connie Bowens | Licensed Practical Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2020-04-06 |
| 1639708233 | Zackary James Ladyman | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-06 |
| 1285269878 | Jennifer Cooper | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-03-04 |
| 1255898516 | Minette A Hafford | Licensed Practical Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2019-02-22 |
| 1043782303 | Susan Dawn Elsworth | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-12-27 |
| 1366920779 | Bonnie Marie Hunter | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-07-30 |
| 1538646336 | Leann Arlene Brown | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-07-24 |
| 1538653621 | Sheila Diane Hodge | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-06-21 |
| 1437658341 | Amanda Bishop | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-02-06 |
| 1255848883 | Karen Richey | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-01-04 |
| Find all providers in POPLAR BLUFF | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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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.