JILL KATHLEEN OTTO (NPI# 1306271382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306271382 |
| Entity Type | Individual |
| Full Name | JILL KATHLEEN OTTO |
| Credential | LPN |
| Practice Address |
2307 Gordon Cooper Dr Shawnee OK 74801-9007 |
| Practice Telephone | 4052735236 |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2013-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 62862 | OK | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073918249 | Jill Otto | Pharmacist | 2300 Holcomb Bridge Rd, Roswell, GA 30076-3481 | 2014-10-29 |
| Street Address |
2307 GORDON COOPER DR |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74801-9007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598752503 | Kent H Potts | Internal Medicine | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2005-10-04 |
| 1619505179 | Kiley Nicole Henderson | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-03-31 |
| 1801422944 | Joni Pataki | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-03-20 |
| 1265063960 | Stephanie Alvillar | Nurse Practitioner | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-01-31 |
| 1629618640 | Savannah Nycole Bagwell | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-01-07 |
| 1770130379 | Darci Leigh Jenkins | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-08-20 |
| 1356997423 | Christina Marie Trout | Registered Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-08-14 |
| 1720630262 | Dayna Kathleen Grandstaff | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-07-15 |
| 1891251575 | Monica Jinkins | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-02-18 |
| 1700351392 | Shelby Janae Parsons | Registered Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2018-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538609037 | Melissa Lanier | Specialist | 801 N. Louisa, Shawnee, OK 74801 | 2017-03-02 |
| 1518365287 | Melanie A. Croy | Counselor | 1605 N. Harrison, Shawnee, OK 74801 | 2014-12-12 |
| 1134532229 | Megan Malouf | Registered Nurse | 2307 Gordon Cooper Dr., Shawnee, OK 74801 | 2014-06-05 |
| 1063836609 | Daniel Antwain Shaw | Counselor | 605 S. Pottenger Ave, Shawnee, OK 74801 | 2014-02-18 |
| 1639514862 | Cheryl Jeannette Left Hand | Counselor | 101 N. Union, Shawnee, OK 74801 | 2013-05-01 |
| 1881948644 | Lena I Samilton | Counselor | 319 S. Kennedy Ave., Apt.112, Shawnee, OK 74801 | 2012-11-01 |
| 1235433681 | Jenifer Sloan | Case Manager/Care Coordinator | 2029 S. Gordon Cooper Dr., Shawnee, OK 74801 | 2010-12-28 |
| 1295854958 | Jack C Luman | Dentist | 1410 N Harrison St, Shawnee, OK 74801 | 2007-03-27 |
| 1942375274 | M Gerald Ball | Psychologist | 819 North Kickapoo, Shawnee, OK 74801 | 2006-11-21 |
| 1205912573 | Regina Steciak Tanner | Physical Therapist | 909 N Kickapoo, Shawnee, OK 74801 | 2006-10-31 |
| Find all providers in zip 74801 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: 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 |
|---|---|---|---|---|
| 1851635445 | Melonie B Taylor | Licensed Practical Nurse | 5516 Caenen St, Shawnee, KS 66216-1923 | 2012-11-20 |
| 1851689723 | Amanda Mae Sims | Licensed Practical Nurse | 1300 Rickey Rd, Shawnee, OK 74801-5414 | 2011-07-13 |
| 1871100255 | Rachel Louise Clark | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2020-09-29 |
| 1619505179 | Kiley Nicole Henderson | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-03-31 |
| 1801422944 | Joni Pataki | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-03-20 |
| 1629618640 | Savannah Nycole Bagwell | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-01-07 |
| 1770130379 | Darci Leigh Jenkins | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-08-20 |
| 1720630262 | Dayna Kathleen Grandstaff | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-07-15 |
| 1750848339 | Kinsey Hall | Licensed Practical Nurse | 101 N Union Ave, Shawnee, OK 74801-7067 | 2019-03-01 |
| 1427515568 | Markie Ryan Carlock | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2019-02-25 |
| Find all providers in SHAWNEE | ||||
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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.