MRS. JAREKA LYNNE ANDERSON (NPI# 1306300090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306300090 |
| Entity Type | Individual |
| Full Name | MRS. JAREKA LYNNE ANDERSON |
| Practice Address |
601 S Clay St Ste 104 Ennis TX 75119-5771 |
| Mailing Address |
601 S Clay St Ste 104 Ennis TX 75119-5771 |
| Practice Telephone | 9728756600 |
| Mailing Telephone | 2812216605 |
| Enumeration Date | 2019-01-26 |
| Last Update Date | 2020-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP140317 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
601 S CLAY ST STE 104 |
| City | ENNIS |
| State | TX |
| Zip Code | 75119-5771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649642497 | Sheletha Renee Bratton | Nurse Practitioner | 601 S Clay St Ste 104, Ennis, TX 75119-5771 | 2015-10-20 |
| 1912549874 | Precious Antonio | Family Medicine | 601 S Clay St Ste 104, Ennis, TX 75119-5771 | 2019-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174121859 | Alexandria Etuk | Pharmacist | 101 Sh-437 Spur, Ennis, TX 75119 | 2020-10-14 |
| 1285279158 | Oluchi Ozumba Md Pa | Pain Medicine | 601 S Cly St, Suite 104, Ennis, TX 75119 | 2019-11-14 |
| 1952806085 | Ikids Pediatric Dentistry Ennis, Pllc | Dentist | 711 S Clay St Ste A, Ennis, TX 75119 | 2018-03-29 |
| 1609382068 | Living Single LLC | Residential Treatment Facility, Physical Disabilities | 809 E. Denton Street, Ennis, TX 75119 | 2017-12-21 |
| 1912363300 | Erin Denise Jackson | Counselor | 219 W. Brown St, Suite A, Ennis, TX 75119 | 2016-01-14 |
| 1164769139 | Matthew Garrett Cooper | Nurse Anesthetist, Certified Registered | 2201 W. Lampasas Street, Ennis, TX 75119 | 2013-01-11 |
| 1922343805 | Braces R Us PC | Dentist | 1012 E. Ennis Ave. Ste. C, Ennis, TX 75119 | 2012-12-04 |
| 1154684355 | Stefanie Nicole Rust | Emergency Medicine | 2201 West Lampasas Street, Ennis, TX 75119 | 2012-06-21 |
| 1265710909 | Traditions Health Care of Ennis, LLC | Home Health | 109 Southwest Main Street, Suite A, Ennis, TX 75119 | 2011-07-29 |
| 1578792370 | Peak Physical Therapy and Rehabilitation LLC | Physical Therapist | 2200 Physicians Blvd, Ste D, Ennis, TX 75119 | 2009-07-14 |
| Find all providers in zip 75119 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639654304 | Christine Marie Fanelli | Nurse Practitioner | 28 Coyote Trl, Ennis, MT 59729-9187 | 2018-09-28 |
| 1992272991 | Tory Magdalene Simpson | Nurse Practitioner | 2200 W Ennis Ave, Ennis, TX 75119-8054 | 2018-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306245 | Julie Gunnarson | Nurse Practitioner | 435 Tioga St, Burleson, TX 76028-8197 | 2020-11-03 |
| 1033710488 | Angela Renee Aston | Nurse Practitioner | 805 Kelly Creek, Bulverde, TX 78163 | 2020-11-03 |
| 1629678347 | Prime Telecare LLC | Nurse Practitioner | 2251 Bagdad Rd Unit 102, Cedar Park, TX 78613-6521 | 2020-10-30 |
| 1063012508 | Kelsey Jean Reisch | Nurse Practitioner | 5001 Orleans Cir, Rowlett, TX 75088-6175 | 2020-10-26 |
| 1124628557 | Jessica Buchanan | Nurse Practitioner | 212 Sheridan Loop, Belton, TX 76513-8024 | 2020-10-26 |
| 1811596323 | Rachel Christine Jarrell | Nurse Practitioner | 10080 Research Forest Dr, The Woodlands, TX 77354-6780 | 2020-10-26 |
| 1356940837 | Katherine Anna Nack | Nurse Practitioner | 6100 Harris Pkwy Ste 285, Fort Worth, TX 76132-4127 | 2020-10-26 |
| 1558960104 | Suzette Roberts | Nurse Practitioner | 2505 Pebble Lodge Ln, Friendswood, TX 77546-5587 | 2020-10-23 |
| 1982203675 | Ilse Deyanire Trevino | Nurse Practitioner | 6233 Tepepan Dr, Brownsville, TX 78521-7135 | 2020-10-22 |
| 1629677612 | Laurel Sunde | Nurse Practitioner | 11111 Research Blvd-ll2, Austin, TX 78759 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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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.