KATINA MALLORY (NPI# 1215582663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215582663 |
| Entity Type | Individual |
| Full Name | KATINA MALLORY |
| Practice Address |
621 Russell Dr Daytona Beach FL 32114-5141 |
| Practice Telephone | 3868717368 |
| Mailing Telephone | 3868717368 |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2019-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | RN9180804 | FL | Nursing Service Providers |
| Street Address |
621 RUSSELL DR |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-5141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033585831 | Danielle Lawanna Jackson | Registered Nurse | 213 Birkdale Dr, Daytona Beach, FL 32124-2053 | 2015-08-15 |
| 1104262831 | Beth Pierre Wright | Registered Nurse | 6 Azalea Dr, Daytona Beach, FL 32124-3613 | 2013-05-21 |
| 1245392802 | Marigold Haresco Santos | Registered Nurse | 305 Dahoon Holly Dr, Daytona Beach, FL 32117-7121 | 2006-12-13 |
| 1215912027 | Vicki L Wilcoxson | Registered Nurse | 303 N Clyde Morris Blvd Ste 302, Daytona Beach, FL 32114-2709 | 2005-12-14 |
| 1740287747 | Catherine Virginia Root | Registered Nurse | 1220 Willis Ave, Daytona Beach, FL 32114-2810 | 2005-07-05 |
| 1235620527 | Precious Monique Spencer | Registered Nurse | 1673 Mason Ave, Daytona Beach, FL 32117-5515 | 2018-05-23 |
| 1124537592 | Beverly Jean Craigle | Registered Nurse | 1673 Mason Ave, Daytona Beach, FL 32117-5515 | 2017-09-28 |
| 1427575992 | Kaitlyn Troftgruben | Registered Nurse | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2017-08-25 |
| 1053837344 | Matthew Frederick Byron | Registered Nurse | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2017-08-17 |
| 1578007068 | Jennifer Ciara Saccente | Registered Nurse | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2016-12-19 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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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.