MICHELLE ENGDAYEHU (NPI# 1205292935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205292935 |
Entity Type | Individual |
Full Name | MICHELLE ENGDAYEHU |
Other Name | MICHELLE APPLE |
Credential | RN FNP |
Practice Address |
707 Hollybrook Dr Longview TX 75605 |
Mailing Address |
Po Box 610393 Dallas TX 75261-0393 |
Practice Telephone | 9032916149 |
Practice Fax Number | 9032916160 |
Mailing Telephone | 9032916187 |
Mailing Fax Number | 9032371810 |
Enumeration Date | 2016-01-11 |
Last Update Date | 2019-06-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP129817 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 355029503 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
307 W Upshur Ave, Gladewater, TX 756472121 | 9038452159 | 9038455451 |
Street Address |
707 HOLLYBROOK DR |
City | LONGVIEW |
State | TX |
Zip Code | 75605 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922003680 | Pavan Saridena | Internal Medicine | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2005-06-17 |
1336787324 | Hannah Joy Harrison | Nurse Practitioner | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2019-12-20 |
1932640349 | Associated Clinicians of East Texas | Allergy & Immunology | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2017-03-17 |
1154786184 | Sheena Shirley | Nurse Practitioner | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2015-12-17 |
1376938126 | Hawner Plastic Surgery Associates | Plastic Surgery | 707 Hollybrook Dr, Suite 400, Longview, TX 75605-2410 | 2015-03-30 |
1144662032 | Tracy Leach | Nurse Practitioner | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2013-07-22 |
1841564572 | Diagnostic Clinic of Longview | Durable Medical Equipment & Medical Supplies | 707 Hollybrook Dr, Suite 500, Longview, TX 75605-2410 | 2012-02-27 |
1144590894 | Diagnostic Clinic of Longview | Allergy & Immunology | 707 Hollybrook Dr, Suite 504, Longview, TX 75605-2410 | 2012-01-11 |
1275832479 | Darvy Lee Mann | Pediatrics | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2011-03-28 |
1538490297 | Kimberly Anne Wyatt | Physician Assistant | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2010-01-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
Find all providers in zip 75605 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154920247 | Lisa Kalynn Sanders | Nurse Practitioner | 2128 Page Creek Trl, Longview, TX 75601-0007 | 2020-10-20 |
1265030993 | Sarah Dawson | Nurse Practitioner | 2040 Eden Dr, Longview, TX 75601-3415 | 2020-10-14 |
1104455716 | Carol Henry | Nurse Practitioner | 287 E Cliffwood St, Longview, TX 75603-7556 | 2020-04-06 |
1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
1649821901 | Heather M Wilson | Nurse Practitioner | 2828 Bill Owens Pkwy Ste B, Longview, TX 75605-2102 | 2019-09-26 |
1942777826 | Cami Jo Tice-harouff | Nurse Practitioner | 16 Ramblewood Dr, Longview, TX 75605-3351 | 2018-10-29 |
1346778685 | Kyle Patrick Urbanek | Nurse Practitioner | 705 E Marshall Ave Ste 5000, Longview, TX 75601-5660 | 2017-05-31 |
1417481623 | Cody Castle | Nurse Practitioner | 1103 Eden Dr, Longview, TX 75605-3114 | 2017-04-13 |
1134570856 | Virginia Hardaway | Nurse Practitioner | 2953 Country Club Rd W, Longview, TX 75602-6861 | 2016-06-23 |
1275994824 | Alto Behavioral Health Services Pllc | Nurse Practitioner | 827 Lansing Switch Rd, Longview, TX 75602-7102 | 2016-03-10 |
Find all providers in LONGVIEW |
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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.