MRS. CORISSA VIDAL (NPI# 1134570278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134570278 |
| Entity Type | Individual |
| Full Name | MRS. CORISSA VIDAL |
| Credential | PMHNP-BC |
| Practice Address |
1026 A Ave Ne Cedar Rapids IA 52402-5036 |
| Practice Telephone | 5635030306 |
| Mailing Telephone | 5635030306 |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
G126019 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1026 A AVE NE |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52402-5036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245396 | Lileah F Harris | Pathology | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2005-06-16 |
| 1568063667 | Maria Swisher | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2020-11-04 |
| 1306453121 | Kathryn Elizabeth Farley | Psychologist | 1026 A Ave Ne, Cedar Rapids, IA 52402-5074 | 2020-09-25 |
| 1770197436 | Brittany Brdicko | Social Worker | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2020-09-01 |
| 1396371563 | Anthony E Dallago | Registered Nurse | 1026 A Ave Ne, Cedar Rapids, IA 52402-5074 | 2020-03-19 |
| 1588299622 | Michael Sanders | Occupational Therapist | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2020-03-09 |
| 1467084319 | Julie Ann Karlan | Pharmacist | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2020-02-09 |
| 1871149914 | Tatjana Tajci Covic | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2019-08-14 |
| 1437717741 | Abigail Lynn Crow | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2019-06-01 |
| 1669931382 | Med-trans Corporation | Ambulance | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2019-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639790520 | Sara Ann Rausch | Counselor | 1533 1 Ave Se, Cedar Rapids, IA 52402 | 2020-05-01 |
| 1558995589 | Jennifer Christine Hohneke | Nurse Practitioner | St. Luke's Transitional Care Center, 1420 Unitypoint Way, Cedar Rapids, IA 52402 | 2020-02-28 |
| 1073008314 | Benjamin Randall Groth | Optometrist | 576 Boyson Rd Ne Ste 104, Cedar Rapids, IA 52402 | 2018-06-28 |
| 1992228621 | Synona Culbertson | Counselor | 4403 1st Ave Ne, Suite L15, Cedar Rapids, IA 52402 | 2017-07-25 |
| 1083136410 | Compassion North America Home Health Services Corp | Hospice Care, Community Based | 1570 42nd Street Ne, Suite #2a, Cedar Rapids, IA 52402 | 2017-07-07 |
| 1861819732 | Arj Infusion Services, Inc. | Home Infusion | 1847 First Ave Se, Suite 100, Cedar Rapids, IA 52402 | 2014-03-27 |
| 1639475197 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 4444 1st Ave Ne Ste 575, Cedar Rapids, IA 52402 | 2011-02-01 |
| 1437452919 | Empowering Families Inc | Early Intervention Provider Agency | 5005 Blairsforest Way, Cedar Rapids, IA 52402 | 2010-12-06 |
| 1184937476 | Jennifer Becker | Counselor | 3745 Center Point Rd Ne Ste A, Cedar Rapids, IA 52402 | 2010-07-15 |
| 1215179817 | William H Fletcher | Hearing Instrument Specialist | 3741 Center Point Rd Ne, Cedar Rapids, IA 52402 | 2009-03-27 |
| Find all providers in zip 52402 | ||||
| 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 |
|---|---|---|---|---|
| 1083224844 | Amy Leclere | Nurse Practitioner | 404 Stonehaven Ln Ne, Cedar Rapids, IA 52402-1451 | 2020-08-06 |
| 1841300183 | Kristen Paige Richardson | Nurse Practitioner | 1231 Park Pl Ne, Suite Falcon, Cedar Rapids, IA 52402-2018 | 2006-08-30 |
| 1619598869 | Katherine Shea | Nurse Practitioner | 520 11th St Nw, Cedar Rapids, IA 52405-3811 | 2020-04-29 |
| 1629617469 | Amy S Morin | Nurse Practitioner | 520 11th St Nw, Cedar Rapids, IA 52405-3811 | 2019-12-26 |
| 1619460201 | Ikama Sasa | Nurse Practitioner | 520 11th St Nw, Cedar Rapids, IA 52405-3811 | 2018-06-08 |
| 1427408715 | Daniell Don Darbyshire | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2016-06-16 |
| 1467802124 | Jessica Rae Thomas | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2016-06-14 |
| 1164821336 | Helga-margot Aldape O'brien | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2014-08-14 |
| 1821333774 | Brittni M Benda | Nurse Practitioner | 1026 A Ave Ne, Cedar Rapids, IA 52402-5036 | 2012-12-04 |
| 1740532803 | Jamie Lynn Smith | Nurse Practitioner | 701 10th St Se, Mercy Outpatient Psychiatry, Cedar Rapids, IA 52403-1251 | 2012-10-12 |
| Find all providers in CEDAR RAPIDS | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52402 |
Please comment or provide details below to improve the information on MRS. CORISSA VIDAL.
| 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.