MARIA D. LASTOVKA (NPI# 1265729925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265729925 |
| Entity Type | Individual |
| Full Name | MARIA D. LASTOVKA |
| Credential | N.P. |
| Practice Address |
127 Crestview Park Dr Suite 205 Dickson TN 37055-2855 |
| Mailing Address |
127 Crestview Park Dr Suite 209 Dickson TN 37055-2855 |
| Practice Telephone | 6154414562 |
| Practice Fax Number | 6154461357 |
| Mailing Telephone | 6154465121 |
| Mailing Fax Number | 6154461357 |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2017-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APN15909 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1525572 | 05 |
| Street Address |
127 CRESTVIEW PARK DR SUITE 205 |
| City | DICKSON |
| State | TN |
| Zip Code | 37055-2855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073516001 | David L Ross | Internal Medicine | 127 Crestview Park Dr, Dickson, TN 37055-2850 | 2005-05-23 |
| 1669987012 | Daniel David Ring | Physician Assistant | 127 Crestview Park Dr, Dickson, TN 37055-2855 | 2017-12-07 |
| 1578082178 | Anna C Gorzny | Nurse Practitioner | 127 Crestview Park Dr, Dickson, TN 37055-2855 | 2017-09-14 |
| 1417209941 | Jennifer Lee Taylor | Nurse Practitioner | 127 Crestview Park Dr, Dickson, TN 37055-2855 | 2012-10-08 |
| 1962753681 | Tracut LLC | Clinic/Center | 127 Crestview Park Dr, 207, Dickson, TN 37055-2855 | 2012-09-20 |
| 1477822336 | Dickson Orthotics & Prosthetics | Durable Medical Equipment & Medical Supplies | 127 Crestview Park Dr, Suite 104, Dickson, TN 37055-2855 | 2011-12-22 |
| 1437386349 | Dickson Medical Equipment, Inc. | Prosthetic/Orthotic Supplier | 127 Crestview Park Dr, Ste. 104, Dickson, TN 37055-2850 | 2009-06-18 |
| 1881834687 | Dickson Medical Associates, PC | Allergy & Immunology | 127 Crestview Park Dr, Dickson, TN 37055-2850 | 2009-03-06 |
| 1003099359 | Luma Kharabsheh | Internal Medicine | 127 Crestview Park Dr, Dickson, TN 37055-2855 | 2007-12-10 |
| 1043435068 | Sowmini Oomman | Psychiatry & Neurology | 127 Crestview Park Dr, Suite 201, Dickson, TN 37055 | 2007-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406186 | Raven Julia Jackson | Dentist | 445 Tn-46 S, Dickson, TN 37055 | 2020-08-03 |
| 1336767839 | Logan Newman | Student in an Organized Health Care Education/Training Program | 102 Us70 East, Suite 2, Dickson, TN 37055 | 2020-07-10 |
| 1720575012 | Vb Tennessee I Pllc | Dentist | 2027 Thornton Dr, Dickson, TX 37055 | 2018-04-23 |
| 1376075358 | Sharon Elizabeth Sharber | Nurse Practitioner | 111 Highway 70 E Ste E, Dickson, TN 37055 | 2017-03-29 |
| 1992255921 | Karen Alonzo | Occupational Therapy Assistant | 312 N Charlotte St, Dickson, TN 37055 | 2016-10-13 |
| 1356727408 | Aurora Pharmacy Inc | Pharmacy | 318 East College Street, Suite 102, Dickson, TN 37055 | 2015-07-30 |
| 1295121820 | Jeffrey Nicholas Williams | Pharmacy Technician | 120 Brazzell Rd, Dickson, TN 37055 | 2015-04-10 |
| 1760894398 | Joshua A. Vaughn | Physical Therapist | 766 Highway 46 South, Dickson, TN 37055 | 2014-06-02 |
| 1902217292 | Keith Payton | Dentist | 217 Highway 46 Ste D, Dickson, TN 37055 | 2014-05-08 |
| 1073953840 | John Harrison | Dentist | 134 Us-70, Dickson Pediatric Dentistry, Dickson, TN 37055 | 2013-06-26 |
| Find all providers in zip 37055 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071691 | Kelley J Sharp | Nurse Practitioner | 110 Mathis Dr, Suite 103, Dickson, TN 37055-2000 | 2005-05-24 |
| 1659444925 | Kimberly L Ray Pllc | Nurse Practitioner | 2409 Highway 70 E, Suite 4 Or 5, Dickson, TN 37055-6126 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003416330 | Laura Jean Schmid | Nurse Practitioner | 2200 Childrens Way Ste 3103, Nashville, TN 37232-0034 | 2020-10-27 |
| 1801495338 | Heidi Bevans | Nurse Practitioner | 1440 Cedar Ln, Tullahoma, TN 37388-2485 | 2020-10-26 |
| 1629683453 | Monique Kyles | Nurse Practitioner | 148 Marrakesh Cir, Memphis, TN 38103-5830 | 2020-09-09 |
| 1164034013 | Donte Leonard | Nurse Practitioner | 952 Dolly Parton Pkwy, Sevierville, TN 37862-3707 | 2020-08-21 |
| 1114545050 | Regina Jill Brown | Nurse Practitioner | 1441 Guthrie Dr Nw, Cleveland, TN 37311-3642 | 2020-07-07 |
| 1295350361 | Amber Rose King | Nurse Practitioner | 439 N Graham St, Memphis, TN 38122-3831 | 2020-06-14 |
| 1346869302 | Ashley O'brien | Nurse Practitioner | 1044 Oak Drive, White Bluff, TN 37187-3718 | 2020-04-10 |
| 1487298634 | Madison Hatfield | Nurse Practitioner | 2200 Childrens Way Fl 8, Nashville, TN 37232-0005 | 2019-10-31 |
| 1184267270 | Mary Elizabeth Coletti | Nurse Practitioner | 1029 W Main St # 3301, Lebanon, TN 37087-3351 | 2019-10-22 |
| 1508408956 | Stephanie Nidiffer | Nurse Practitioner | 3328 Jenkins Rd Ste 200, Chattanooga, TN 37421-1298 | 2019-10-16 |
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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.