ANNALISA KAY MITKISH (NPI# 1114274545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114274545 |
| Entity Type | Individual |
| Full Name | ANNALISA KAY MITKISH |
| Credential | FNP |
| Practice Address |
3555 S National Ave Springfield MO 65807-7310 |
| Mailing Address |
Po Box 9007 Springfield MO 65808-9007 |
| Practice Telephone | 4178753800 |
| Mailing Telephone | 4178753462 |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2017-07-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2012026933 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | NP LICENSE | 2012026933 | 01 |
| Street Address |
3555 S NATIONAL AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-7310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124009212 | Christopher M Miller | Orthopaedic Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2005-11-07 |
| 1881218477 | Kristen Jean Cheever | Nurse Practitioner | 3555 S National Ave, Springfield, MO 65807-7310 | 2020-05-30 |
| 1124583968 | Christine J Palmer | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2019-02-06 |
| 1114428547 | Jordan Phenicie | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2018-02-21 |
| 1194224949 | Courtney Ray | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2018-02-07 |
| 1427444686 | Jorden Tyler Komm | Emergency Medicine | 3555 S National Ave, Springfield, MO 65807-7310 | 2015-04-14 |
| 1386041739 | Chris Foster | Specialist/Technologist | 3555 S National Ave, Springfield, MO 65807-7310 | 2014-12-01 |
| 1568881407 | Connor Barnes | Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2014-04-08 |
| 1982943502 | Joseph M Meystrik | Nurse Practitioner | 3555 S National Ave, Springfield, MO 65807-7310 | 2013-02-01 |
| 1326386863 | Erin Beth Clayman | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2013-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
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| 1275146268 | Courtney Wilbern | Nurse Practitioner | 1200 W Centre St, Springfield, IL 62704-5812 | 2020-08-28 |
| 1588276240 | Andrew Ronald Mouser | Nurse Practitioner | 607 Prospect Rd, Springfield, PA 19064-2819 | 2020-08-23 |
| 1821609082 | William Coleman Bryant | Nurse Practitioner | 5552 W Longleaf Dr, Springfield, MO 65802-7834 | 2020-08-12 |
| 1386254399 | Ashley Lynn Murray | Nurse Practitioner | 2443 E Greenwood St, Springfield, MO 65804-3907 | 2020-08-04 |
| 1679182281 | Erica Gail Hunt | Nurse Practitioner | 2813 Haverford Rd, Springfield, IL 62704-4267 | 2020-07-29 |
| 1063020063 | Gage Azeez | Nurse Practitioner | 46 Timber Ln, Springfield, MA 01119-2828 | 2020-07-16 |
| 1033737440 | Janne L Nicholson | Nurse Practitioner | 8360 Dunham Ct Apt G, Springfield, VA 22152-1122 | 2020-07-13 |
| 1922623156 | Amanda E Hildebrand | Nurse Practitioner | 3370 Carman Ave, Springfield, IL 62703-4642 | 2020-06-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
Please comment or provide details below to improve the information on ANNALISA KAY MITKISH.
| 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.