MAYA MIKKIA BRADFORD (NPI# 1346895646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346895646 |
| Entity Type | Individual |
| Full Name | MAYA MIKKIA BRADFORD |
| Credential | LPN |
| Practice Address |
2701 17th St Rock Island IL 61201-5351 |
| Practice Telephone | 3097792031 |
| Mailing Telephone | 3097792031 |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | P63115 | IA | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9537 12160 Utah Avenue, Davenport, IA 52804 | 5633261150 |
| Street Address |
2701 17TH ST |
| City | ROCK ISLAND |
| State | IL |
| Zip Code | 61201-5351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142629 | Deepak Ahuja | Internal Medicine | 2701 17th St, Rock Island, IL 61201-5351 | 2005-05-31 |
| 1205436052 | Penny Ann Liebbe | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-30 |
| 1740880863 | Ginger I Busby | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-28 |
| 1366041022 | Elizabeth Erin Montgomery | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-22 |
| 1285232587 | Jillian Elizabeth Spragg | Counselor | 2701 17th St, Rock Island, IL 61201-5393 | 2020-10-09 |
| 1902403140 | Kelsey Jean Mickelson | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-01 |
| 1033725452 | Amber Michelle Winters | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-21 |
| 1295341865 | Kaitlyn Dawn Shannon | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-19 |
| 1902412539 | Alex Strupp | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-18 |
| 1861008641 | Leanne Elizabeth Zazzetti | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689206245 | Judy Kay Moore | Technician | 2439 8th Ave, Rock Island, IL 61201 | 2020-02-11 |
| 1053956862 | Christina Beam | Counselor | 1413 40th Street, Rock Island, IL 61201 | 2019-11-15 |
| 1356843817 | Stephanie Kaye Jones | Counselor | 2701 17th St., Rock Island, IL 61201 | 2018-03-01 |
| 1073062030 | Innovative Transport Enterprise, LLC | Non-emergency Medical Transport (VAN) | 2239 24th Street Apt 15c, Rock Island, IL 61201 | 2016-09-30 |
| 1124575733 | Robert Young Center | Community Based Residential Treatment Facility, Mental Illness | 2701 - 17 Street, Rockisland, IL 61201 | 2016-09-01 |
| 1538520903 | James Keith Frainey | Psychologist | 805 19th Street, Transitions Mhs, Rock Island, IL 61201 | 2016-03-14 |
| 1417340837 | Brandon Lee Sachwitz | Physician Assistant | 2701 17th Street, Trinity Medical Center, Rock Island, IL 61201 | 2015-03-10 |
| 1215366679 | Kimberly Lyall | Physical Therapy Assistant | 767 30th Street, Rock Island, IL 61201 | 2013-11-06 |
| 1386080745 | The Abbey Center, LLC | Clinic/Center | 3031 5th Ave., Rock Island, IL 61201 | 2013-05-13 |
| 1487097382 | Joe Lee Westerhof | Veterinarian | 2529 11th St, Rock Island, IL 61201 | 2013-04-10 |
| Find all providers in zip 61201 | ||||
| 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 |
|---|---|---|---|---|
| 1669828091 | Tammy Reed | Licensed Practical Nurse | 627 24th Ave, Rock Island, IL 61201-4142 | 2016-05-04 |
| 1083087720 | Kaylee Nordholm | Licensed Practical Nurse | 4016 9th St, Rock Island, IL 61201-6722 | 2015-11-03 |
| 1578942082 | Cheryl Cole | Licensed Practical Nurse | 4016 9th St, Rock Island, IL 61201-6722 | 2015-05-29 |
| 1295114726 | Betty Hatley | Licensed Practical Nurse | 4016 9th St, Rock Island, IL 61201-6722 | 2015-05-29 |
| 1689053654 | Judy Bowers | Licensed Practical Nurse | 4016 9th St, Rock Island, IL 61201-6722 | 2015-05-24 |
| 1265824072 | Takesha Mcnamee | Licensed Practical Nurse | 4016 9th St, Rock Island, IL 61201-6722 | 2015-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330233 | Candace D Younger | Licensed Practical Nurse | 507 Lickliter St, Benton, IL 62812-2219 | 2020-09-15 |
| 1063025781 | Austin Grant | Licensed Practical Nurse | 205 Joplin St, Benton, IL 62812-2023 | 2020-08-24 |
| 1518570233 | Titilayo Ayeni-sode | Licensed Practical Nurse | 23025 Amber Ln, Richton Park, IL 60471-1281 | 2020-08-24 |
| 1477164929 | Monique L Lee | Licensed Practical Nurse | 8528 S Exchange Ave # 2, Chicago, IL 60617-2541 | 2020-08-10 |
| 1619597291 | Robin Wilson | Licensed Practical Nurse | 842 S 18th Ave, Maywood, IL 60153-1706 | 2020-04-23 |
| 1790319630 | Krystle Ekhoff | Licensed Practical Nurse | 9108 S Troy Ave, Evergreen Park, IL 60805-1628 | 2020-03-01 |
| 1932732237 | Robina Renee Williams | Licensed Practical Nurse | 16313 Turner Ave, Markham, IL 60428-5446 | 2020-02-15 |
| 1417589649 | Lataunja Parese Weaver | Licensed Practical Nurse | 7436 S Ellis Ave, Chicago, IL 60619-2032 | 2020-02-05 |
| 1124667621 | Jacquelyn Cooper | Licensed Practical Nurse | 230 N Lind Ave, Hillside, IL 60162-1538 | 2019-12-31 |
| 1699312587 | Kristi Ann Pittman-spero | Licensed Practical Nurse | 101 N Jefferson Ave, Bradley, IL 60915-1829 | 2019-12-10 |
| Find all providers with the same taxonomy | ||||
| City | ROCK ISLAND |
| Zip Code | 61201 |
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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.