DEANNA MOORMAN (NPI# 1134537632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134537632 |
| Entity Type | Individual |
| Full Name | DEANNA MOORMAN |
| Credential | FNP-BC |
| Practice Address |
2023 Vadalabene Dr Suite 200 Maryville IL 62062-5630 |
| Practice Telephone | 6182887408 |
| Mailing Telephone | 6182887408 |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2015-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 209011286 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
209011286 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2023 VADALABENE DR SUITE 200 |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306825856 | Christina L Midkiff | Obstetrics & Gynecology | 2023 Vadalabene Dr, Ste 200, Maryville, IL 62062-5631 | 2006-01-12 |
| 1346783230 | Jenny M Daniels | Nurse Practitioner | 2023 Vadalabene Dr, Suite 200, Maryville, IL 62062-5630 | 2016-11-23 |
| 1366829608 | Sean M Miller | Physician Assistant | 2023 Vadalabene Dr, Suite 251, Maryville, IL 62062-5630 | 2015-05-06 |
| 1477957827 | Kristen R Kreher | Nurse Practitioner | 2023 Vadalabene Dr, Suite 251, Maryville, IL 62062-5630 | 2014-10-14 |
| 1235578410 | Kathryn Lindsay K Cobb | Nurse Practitioner | 2023 Vadalabene Dr, Maryville, IL 62062-5630 | 2013-06-20 |
| 1912293002 | Maryville Imaging, LLC | Clinic/Center | 2023 Vadalabene Dr, Suite 100, Maryville, IL 62062-5630 | 2011-06-27 |
| 1982902342 | Dr. David B. Yablonsky, D.o., P.C. | Family Medicine | 2023 Vadalabene Dr, Suite 251, Maryville, IL 62062-5630 | 2011-03-09 |
| 1306154984 | Manisha C Shah | Obstetrics & Gynecology | 2023 Vadalabene Dr, Ste 200, Maryville, IL 62062 | 2010-09-17 |
| 1073843967 | Jennifer D Wesselman-williams | Nurse Practitioner | 2023 Vadalabene Dr, Suite 200, Maryville, IL 62062-5630 | 2009-12-28 |
| 1619103819 | Brinley Orthodontics, LLC | Dentist | 2023 Vadalabene Dr, Maryville, IL 62062-5631 | 2009-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255805594 | Sara Marie Grotefendt | Nurse Practitioner | 2016 Vadalabene Dr, Maryville, IL 62062-6901 | 2019-01-21 |
| 1346783230 | Jenny M Daniels | Nurse Practitioner | 2023 Vadalabene Dr, Suite 200, Maryville, IL 62062-5630 | 2016-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396308458 | Alexandra H Pape | Nurse Practitioner | 10260 191st St Ste 100, Mokena, IL 60448-8802 | 2019-04-15 |
| 1306313754 | Klaudia Dorota Niedzwiecki | Nurse Practitioner | 654 W Veterans Pkwy Ste A, Yorkville, IL 60560-2510 | 2018-10-24 |
| 1295226728 | Cortney Elizabeth Patrick | Nurse Practitioner | 2900 Frank Scott Pkwy W Ste 966, Belleville, IL 62223-5000 | 2018-05-21 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1124464110 | Michelle Yonkus | Nurse Practitioner | 500 E 22nd St Ste A, Lombard, IL 60148-6102 | 2013-05-16 |
| 1457600306 | Julie Duff | Nurse Practitioner | 5425 W. Addison, Chicago, IL 60641 | 2012-09-06 |
| 1891067765 | Cynthia Ann Wildemuth | Nurse Practitioner | 2112 25th Avenue, Rock Island, IL 61201 | 2012-02-07 |
| 1174803753 | Patricia J Fiorito | Nurse Practitioner | 801 S Milwaukee Ave # 110, Libertyville, IL 60048-3204 | 2011-08-26 |
| 1619102456 | Vickie Eileen Ellis | Nurse Practitioner | 201 W. Kenyon Rd, Champaign, IL 61820-7892 | 2009-05-22 |
| 1942465554 | Maryann Ulery | Nurse Practitioner | 3 Austrian Ct, Lake In The Hills, IL 60156-6515 | 2008-07-23 |
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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.