MRS. LUCILLE TRAVIS (NPI# 1093206674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093206674 |
| Entity Type | Individual |
| Full Name | MRS. LUCILLE TRAVIS |
| Credential | NP |
| Practice Address |
215 Palisades Dr Dallas GA 30157-0928 |
| Practice Telephone | 6789784947 |
| Mailing Telephone | 6789784947 |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2018-05-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN195568 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
215 PALISADES DR |
| City | DALLAS |
| State | GA |
| Zip Code | 30157-0928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750913349 | Kingdom Healthcare Services | Assisted Living Facility | 215 Palisades Dr, Dallas, GA 30157-0928 | 2020-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608629 | Harshadbhai Vinubhai Patel | Pharmacist | 3615 Marietta Highway, Dallas, GA 30157 | 2020-10-30 |
| 1043852627 | Lindsay Sheets | Dentist | 59 Hillside Trce Ste 105, Dallas, GA 30157 | 2019-10-15 |
| 1619459062 | Emily Nicole Koopman | Specialist/Technologist | 399 Powder Creek Way, Dallas, GA 30157 | 2018-09-02 |
| 1073969861 | Rachel Spencer | Physical Therapist | 99 Hillside Trace, Dallas, GA 30157 | 2016-05-11 |
| 1336514827 | Petal Shields | Community Health Worker | 121 Omega Ct, Dallas, GA 30157 | 2015-12-09 |
| 1851797294 | Annette Moncion | Nurse Practitioner | 32 Midland Lane, Dallas, GA 30157 | 2014-11-12 |
| 1003211079 | Melissa Brice | Lactation Consultant, Non-RN | 430 Parson Rd, Dallas, GA 30157 | 2014-11-03 |
| 1104101690 | Jared Alan Lott | Pharmacist | 303 Charlie Watts Blvd, Dallas, GA 30157 | 2011-10-15 |
| 1972888758 | Lisa Nicole Mcentire | Massage Therapist | 119 Fairview Oak Trace, Dallas, GA 30157 | 2011-10-12 |
| 1548570120 | Chad Stough | Physician Assistant | 2713 Marietta Highway, Suite 122, Dallas, GA 30157 | 2010-10-15 |
| Find all providers in zip 30157 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497290910 | Brenda Renee Matzke | Nurse Practitioner | 7625 Wellcrest Dr, Dallas, TX 75230-4856 | 2016-12-20 |
| 1609282391 | Mildred Onime | Nurse Practitioner | 4400 W University Blvd, Apt: 10306, Dallas, TX 75209-3876 | 2014-07-02 |
| 1598941403 | Jorjanna E Toon | Nurse Practitioner | 5523 Laysan Ct, Dallas, TX 75249-2211 | 2008-01-10 |
| 1801991518 | Kay Karen Redwine | Nurse Practitioner | 703 Mckinney Avenue, Suite 433, Dallas, TX 75202 | 2006-09-14 |
| 1205855830 | Mary J Beine | Nurse Practitioner | 7474 Skillman St Apt 402, Dallas, TX 75231-8328 | 2006-07-18 |
| 1992737480 | Joyce H. Danter | Nurse Practitioner | 4144 N Central Expy Ste 450, Dallas, TX 75204-3132 | 2006-07-07 |
| 1073541439 | Karen Florence Sacks | Nurse Practitioner | Presbyterian Hospital of Dallas 8198 Walnut Hill Ln, Jackson Bld. - Neuroinformation Center 1st Floor, Dallas, TX 75231 | 2006-06-28 |
| 1740810746 | Christen Jill Wolf | Nurse Practitioner | 1441 N Beckley Ave, Dallas, TX 75203-1201 | 2020-01-19 |
| 1679110241 | Asha Alexander | Nurse Practitioner | 9229 Lyndon B Johnson Fwy, Dallas, TX 75243-3405 | 2019-12-03 |
| 1053969766 | Sheila N Behimehr | Nurse Practitioner | 8144 Walnut Hill Ln Ste 800, Dallas, TX 75231-4345 | 2019-08-27 |
| Find all providers in DALLAS | ||||
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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.