MS. KRISTIN L RETTIG (NPI# 1164778767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164778767 |
| Entity Type | Individual |
| Full Name | MS. KRISTIN L RETTIG |
| Credential | PA |
| Practice Address |
5615 Deauville Ste 220 Midland TX 79706-2707 |
| Practice Telephone | 4322215560 |
| Mailing Telephone | 4322215560 |
| Mailing Fax Number | 2547292315 |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA07879 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | DEA | MR5194775 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2021 N Macarthur Blvd, Ste 350, Irving, TX 750612219 | 9722532555 | 9722534217 |
| 204 W Trinity St, Groesbeck, TX 766421324 | 2547293740 | 2547292315 |
| Street Address |
5615 DEAUVILLE STE 220 |
| City | MIDLAND |
| State | TX |
| Zip Code | 79706-2707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588857874 | John William Mathewson | Surgery | 5615 Deauville Ste 220, Midland, TX 79706-2707 | 2007-08-21 |
| 1700413994 | Brittany Vanzandt | Nurse Practitioner | 5615 Deauville Ste 220, Midland, TX 79706-2707 | 2020-03-26 |
| 1447882915 | Rachelle Michelle Campos | Nurse Practitioner | 5615 Deauville Ste 220, Midland, TX 79706-2707 | 2020-02-12 |
| 1952865347 | Andrea Nielsen | Specialist/Technologist | 5615 Deauville Ste 220, Midland, TX 79706-2707 | 2019-01-30 |
| 1467925040 | Kayla Melendez | Nurse Practitioner | 5615 Deauville Ste 220, Midland, TX 79706-2707 | 2019-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376183988 | Sara E Valentine | Nurse Practitioner | 4815 Ih-20 Bl W, Midland, TX 79706 | 2020-01-11 |
| 1508407958 | Vanessa Vazquez | Licensed Practical Nurse | 7701 Wcr 116 Sp63, Midland, TX 79706 | 2019-10-07 |
| 1316420060 | Sandra Carbajal | Licensed Practical Nurse | 2914 Scr 1193, Midland, TX 79706 | 2018-09-10 |
| 1184106429 | Guadalupe Linda Martinez | Registered Nurse | 3103 South County Road 1197, Midland, TX 79706 | 2018-09-04 |
| 1154821999 | Rebecca Gail Hildebrand | Licensed Vocational Nurse | 7701 Wcr 116 #83, Midland, TX 79706 | 2018-02-19 |
| 1174993927 | H-e-b, Lp | Clinical Medical Laboratory | 5407 Andrews Hwy, Midland, TX 79706 | 2015-10-05 |
| 1366623803 | Roddy Strobel Mdpa | Psychiatry & Neurology | 3300 S. Fm 1788, Suite 403, Odessa, TX 79706 | 2007-11-26 |
| 1043270085 | Franklin J Dzida | Orthopaedic Surgery | 5615 Deauville Blvd, Ste 220, Midland, TX 79706 | 2006-03-24 |
| 1114996048 | Stephanie Ann Schoen-orr | Counselor | 10008 Pilot Ave, Midland, TX 79706 | 2006-03-14 |
| 1790770402 | Gerardo Escobedo | Ophthalmology | 10100 Loop 40 West, Midland, TX 79706 | 2005-09-19 |
| Find all providers in zip 79706 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417509332 | Ananya Das | Physician Assistant | 3600 North Garfield St., Midland, TX 79705 | 2019-07-11 |
| 1023679867 | Michael Daniel Howson | Physician Assistant | 2592 N Tamarack Dr, Midland, MI 48642-7888 | 2019-06-24 |
| 1952865057 | Morgan Elizabeth Sims | Physician Assistant | 4214 Andrews Hwy Ste 110, Midland, TX 79703-4864 | 2019-01-23 |
| 1811470867 | Catherine Rhea Randall | Physician Assistant | 4401 Campus Ridge Dr Ste 2040, Midland, MI 48640-6125 | 2018-09-14 |
| 1568973675 | Eric Lee Wright | Physician Assistant | 111 E Wackerly St Ste B, Midland, MI 48642-7043 | 2017-10-16 |
| 1861917718 | Megan Amanda Dawkins | Physician Assistant | 3501 W Illinois Ave, Midland, TX 79703-5606 | 2017-08-11 |
| 1215485719 | Midland Clinic Pllc | Physician Assistant | 801 Tradewinds Blvd, Ste B, Midland, TX 79706-0000 | 2016-09-14 |
| 1336432046 | Ashley Thrasher Bell | Physician Assistant | 3600 N Garfield, Ttuhsc Pa Program, Midland, TX 79707 | 2011-05-27 |
| 1386959039 | Lori R Benninghoff | Physician Assistant | 1900 W Wall, Suite A, Midland, TX 79701-6534 | 2010-08-18 |
| 1902124266 | Deeanna Emmalynn Kenny | Physician Assistant | 4401 Campus Ridge Dr Ste 1000, Midland, MI 48640-6125 | 2010-05-12 |
| Find all providers in MIDLAND | ||||
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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.