ELIZABETH ILLENBERG (NPI# 1295263192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295263192 |
| Entity Type | Individual |
| Full Name | ELIZABETH ILLENBERG |
| Credential | FNP |
| Practice Address |
600 N Jackson St Tullahoma TN 37388-3542 |
| Mailing Address |
151 Edna W Grooms Ln Watertown TN 37184-1078 |
| Practice Telephone | 9315635469 |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
22622 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
600 N JACKSON ST |
| City | TULLAHOMA |
| State | TN |
| Zip Code | 37388-3542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083173488 | Jason A. Martin | Nurse Practitioner | 600 N Jackson St, Tullahoma, TN 37388-3542 | 2019-03-15 |
| 1134531593 | Lisa M Cejka | Nurse Practitioner | 600 N Jackson St, Tullahoma, TN 37388-3542 | 2014-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588183628 | Angela Michelle Sowers | Dietitian, Registered | 1801 North Jackson St, Tullahoma, TN 37388 | 2017-09-09 |
| 1194242669 | Haley D Stewart | Speech-Language Pathologist | Top Rehab Services, Inc, 2110 N. Jackson Street, Tullahoma, TN 37388 | 2017-08-25 |
| 1295263150 | Kelli Elaine Spencer | Nurse Practitioner | Partners for Healing, 109 West Blackwell Street, Tullahoma, TN 37388 | 2017-05-23 |
| 1932651486 | Adam Snider | Physical Therapy Assistant | 1321 Cedar Lane, Tullahoma, TN 37388 | 2016-11-01 |
| 1891240743 | Elizabeth Riddle | Nurse Practitioner | 1805 N Jackson St Ste 11, Tullahoma, TN 37388 | 2016-08-22 |
| 1720437189 | Ronda Schrimsher | Peer Specialist | 108 E Lauderdale St, Tullahoma, TN 37388 | 2016-06-07 |
| 1003298639 | Jeanetta Clark | Counselor | 1803 N. Jackson St, Centerstone of Tennessee, Tullahoma, TN 37388 | 2015-06-19 |
| 1285051698 | Ashley Mcmurtry | Physical Therapist | 2110 N. Jackson Street, Tullahoma, TN 37388 | 2014-03-24 |
| 1093150575 | Orthopedic Braces | Case Management | 206 Westside Dr, Tullahoma, TN 37388 | 2013-05-09 |
| 1427397199 | Kristina Danette Carter | Pharmacist | 104 North Jackson Street, Tullahoma, TN 37388 | 2013-01-31 |
| Find all providers in zip 37388 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780204339 | Brandi Leanne Thoma | Nurse Practitioner | 1729 Country Club Dr, Tullahoma, TN 37388-4831 | 2020-04-23 |
| 1770112096 | Evan Smith | Nurse Practitioner | 109 Parkway Pl, Tullahoma, TN 37388-5341 | 2020-04-07 |
| 1205468949 | Stephen Thomas | Nurse Practitioner | 1805 N Jackson St Ste 300, Tullahoma, TN 37388-2293 | 2020-02-11 |
| 1295263150 | Kelli Elaine Spencer | Nurse Practitioner | Partners for Healing, 109 West Blackwell Street, Tullahoma, TN 37388 | 2017-05-23 |
| 1942744339 | Amg - Southern Tennessee, LLC | Nurse Practitioner | 108 W Blackwell St, Tullahoma, TN 37388-3505 | 2016-12-05 |
| 1053780478 | Leslie Lynette Myers | Nurse Practitioner | 104 Westside Dr, Tullahoma, TN 37388-3253 | 2015-09-15 |
| 1417385212 | Carol R Landerman | Nurse Practitioner | 1330 Cedar Ln Ste 900, Tullahoma, TN 37388-2286 | 2013-10-15 |
| 1457634834 | Tina A. Ping | Nurse Practitioner | 1210 S Jackson St, Tullahoma, TN 37388-4386 | 2011-09-22 |
| 1972892354 | Katherine M Gilliland | Nurse Practitioner | 1805 North Jackson St., Suite 100, Tullahoma, TN 37388 | 2011-04-06 |
| 1942532163 | Tonia Gale Christian | Nurse Practitioner | 100 Hunters Ln Ste 100b, Tullahoma, TN 37388-8263 | 2010-02-13 |
| Find all providers in TULLAHOMA | ||||
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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.