MRS. MARISSA CHRISTINE MYRES (NPI# 1073917258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073917258 |
| Entity Type | Individual |
| Full Name | MRS. MARISSA CHRISTINE MYRES |
| Credential | APN |
| Practice Address |
3308 W Chartwell Rd Peoria IL 61614-2322 |
| Practice Telephone | 3096917640 |
| Practice Fax Number | 3096917643 |
| Mailing Telephone | 3096917640 |
| Mailing Fax Number | 3096917643 |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2014-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041.385496 | IL | Nursing Service Providers |
| Y | 364S00000X | Clinical Nurse Specialist | 209.012031 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124495924 | Marissa Liana Myres | Behavioral Analyst | 2054 Lindsay Rd, Everson, WA 98247-8218 | 2015-08-27 |
| Street Address |
3308 W CHARTWELL RD |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053340620 | Endocrine & Diabetes, Sc | Internal Medicine | 3308 W Chartwell Rd, Peoria, IL 61614-2322 | 2006-07-03 |
| 1992738728 | Jeffrey Y Chang | Internal Medicine | 3308 W Chartwell Rd, Peoria, IL 61614-2322 | 2006-07-07 |
| 1639108202 | Thomas R Dorsch | Internal Medicine | 3308 W Chartwell Rd, Peoria, IL 61614-2322 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1144564188 | Melanie Ann Reeves | Clinical Nurse Specialist | 530 Ne Glen Oak Ave Po Box G13, Peoria, IL 61637-0001 | 2012-11-15 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1730713546 | Kim M Scott | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-02 |
| 1063936573 | Cheryl Herrmann | Clinical Nurse Specialist | 112 Ne Crescent Ave, Peoria, IL 61606-1901 | 2017-07-27 |
| 1477903797 | Lindsey Swischuk | Clinical Nurse Specialist | 114 W Stratford Dr, Peoria, IL 61614-7301 | 2016-06-17 |
| 1407259559 | Carissa Gorham | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-10-03 |
| 1184026940 | Emily Mckenna | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-09-23 |
| 1295141471 | Kara Lynn Marino | Clinical Nurse Specialist | 900 Main St Ste 100, Peoria, IL 61602-5003 | 2014-07-08 |
| 1841638855 | Sharon Marie Damron | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-06-12 |
| Find all providers in PEORIA | ||||
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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.