MARY PATRICIA HEADLEY (NPI# 1114006665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114006665 |
| Entity Type | Individual |
| Full Name | MARY PATRICIA HEADLEY |
| Credential | FNP |
| Practice Address |
3100 Mckinnon St Dallas TX 75201-1044 |
| Mailing Address |
5838 Edison Pl Ste 100 Carlsbad CA 92008-5520 |
| Practice Telephone | 2147548700 |
| Practice Fax Number | 4698931938 |
| Mailing Telephone | 2144603036 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2017-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
508116 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
22257 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3100 MCKINNON ST |
| City | DALLAS |
| State | TX |
| Zip Code | 75201-1044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992081160 | Deborah Ruth Lanier | Nurse Practitioner | 3100 Mckinnon St, Ste400, Dallas, TX 75201-1044 | 2011-11-01 |
| 1245542976 | Alexander M Tanjuakio | Nurse Practitioner | 3100 Mckinnon St, Suite 400, Dallas, TX 75201-1044 | 2010-07-10 |
| 1396978243 | Jayma Lee Degroot | Nurse Practitioner | 3100 Mckinnon St, Suite 400, Dallas, TX 75201-1044 | 2009-08-26 |
| 1023251535 | Nicole E Shutts | Nurse Practitioner | 3100 Mckinnon St, Dallas, TX 75201-1044 | 2009-04-14 |
| 1649432501 | Kimberly Duffy | Family Medicine | 3100 Mckinnon St, Suite 400, Dallas, TX 75201-1044 | 2008-07-01 |
| 1922135003 | Margaret Clifton Scott | Physician Assistant | 3100 Mckinnon St, Suite 200, Dallas, TX 75201-1044 | 2007-02-27 |
| 1588714018 | Deborah Whitehead Gleaves | Psychologist | 3100 Mckinnon St, Suite 400, Dallas, TX 75201-1044 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945564 | Amanda Michelle Flores | Physician Assistant | 1801 Young St, Dallas, TX 75201 | 2020-09-03 |
| 1992366488 | Anmd Health Pllc | Family Medicine | 1910 Pacific Ave Suite 15700, Dallas, TX 75201 | 2019-06-25 |
| 1972083772 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 2380 N Field St, Dallas, TX 75201 | 2018-08-21 |
| 1861986986 | Stella O Adebusoye | Registered Nurse | 2121 Main St Ste 100, Dallas, TX 75201 | 2018-06-21 |
| 1215432026 | Shawana Harris | Counselor | 1910 Pacific Ave #7024, Dallas, TX 75201 | 2018-03-26 |
| 1285150821 | Lauren Elisabeth Kelling | Nurse Practitioner | 700 N. Pearl St. Suiten208, Dallas, TX 75201 | 2017-08-15 |
| 1962932319 | Jade On | Dentist | 2225 N Harwood St, Dallas, TX 75201 | 2017-06-19 |
| 1053857268 | Lj Dentistry, Pllc | Dentist | 2100 Ross Ave #960, Dallas, TX 75201 | 2017-01-11 |
| 1770946444 | Robin Margolin | Counselor | 1919 Mckinney Ave # 2063, Dallas, TX 75201 | 2016-03-31 |
| 1750767448 | Hcf Web Services | Respite Care | 2320 Taylor St, 2322, Dallas, TX 75201 | 2015-08-04 |
| Find all providers in zip 75201 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366052805 | Deadra Jordan | Nurse Practitioner | 5995 Summerside Dr Unit 795142, Dallas, TX 75379-0095 | 2020-08-07 |
| 1083235691 | Annemarie Osondu Odo | Nurse Practitioner | 9450 Skillman St Ste 120, Dallas, TX 75243-8235 | 2020-05-05 |
| 1740811934 | Kellie Lynn Westmoreland | Nurse Practitioner | 7777 Forest Ln Ste 833, Dallas, TX 75230-2571 | 2020-01-28 |
| 1346871696 | Ebote Ngite Nnoko | Nurse Practitioner | 108 Crescent Woode Dr, Dallas, GA 30157-5725 | 2020-01-27 |
| 1689238461 | Ican Medics and Psych Services Pllc | Nurse Practitioner | 9535 Forest Ln Ste 109, Dallas, TX 75243-5934 | 2019-04-26 |
| 1942773643 | Jo Kutty Kurian | Nurse Practitioner | 6363, Forest Park Road, 7th Floor, Suite 749, Dallas, TX 75390-9121 | 2019-01-04 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1114495983 | Nwamaka Ngumezi | Nurse Practitioner | 3417 Gaston Ave Ste 815, Dallas, TX 75246-2034 | 2018-11-08 |
| 1811406150 | Justin Neal Mehan | Nurse Practitioner | 712 N Washington Ave Ste 411, Dallas, TX 75246-1626 | 2017-09-28 |
| 1114321775 | Shane Tipton | Nurse Practitioner | 6363 Forest Park Road 7th Floor Ste 749, Dallas, TX 75390-4426 | 2014-10-10 |
| 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.