TERESA A LANE (NPI# 1417247776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417247776 |
| Entity Type | Individual |
| Full Name | TERESA A LANE |
| Practice Address |
200 E Pennsylvania Ave Peoria IL 61603-3089 |
| Practice Telephone | 3096244000 |
| Practice Fax Number | 3096244010 |
| Mailing Telephone | 3096244000 |
| Mailing Fax Number | 3096244010 |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2016-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
209008755 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 370662569 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457910382 | Teresa Lynette Lane | Registered Nurse | 12013 181st St E, Puyallup, WA 98374-9161 | 2019-06-13 |
| 1770638397 | Teresa Parham Lane | Nurse Practitioner | 420 Briar Creek Rd, Ellijay, GA 30540-1220 | 2007-01-24 |
| 1801959564 | Teresa Lane | Social Worker | 1107 48th Ave N Ste 310f, Myrtle Beach, SC 29577-5443 | 2006-12-17 |
| 1609014380 | Teresa Lynn Lane | Counselor | 1137 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 | 2009-02-03 |
| 1972667517 | Teresa Kay Lane | Nurse Practitioner | 12 Eastbrook Bnd, Peachtree City, GA 30269-1530 | 2006-12-20 |
| 1699757617 | Teresa Lane | Nurse Anesthetist, Certified Registered | 300 1st Capitol Dr, Saint Charles, MO 63301-2844 | 2005-11-16 |
| Street Address |
200 E PENNSYLVANIA AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603-3089 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912901711 | James W Bauer | Internal Medicine | 200 E Pennsylvania Ave, Ste 105, Peoria, IL 61603-3045 | 2005-06-09 |
| 1205473154 | Gargi Dnyanesh Gupte | Physician Assistant | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2019-12-10 |
| 1487127734 | Stephanie S Beckstrom | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2019-01-09 |
| 1174093009 | Katelyn M Johnson | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-12-04 |
| 1093298127 | Loan T Nguyen | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-09-14 |
| 1922580695 | Anna K Boyce | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-08-30 |
| 1033604855 | Caroline Marie Boczar | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2018-06-25 |
| 1831608991 | Laurel K Donaldson | Audiologist | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2017-09-21 |
| 1851818835 | Cynthia I Guede | Nurse Practitioner | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2017-08-29 |
| 1275986051 | Travis E. Towne | Social Worker | 200 E Pennsylvania Ave, Peoria, IL 61603-3089 | 2016-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 364SA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528351962 | Kristi Kae Williams | Clinical Nurse Specialist | 530 Ne Glenoak Avenue Pob Suite 108, Peoria, IL 61603-3117 | 2011-05-18 |
| 1427356336 | Lissa J Diefendorf | Clinical Nurse Specialist | 403 W Corrington Ave, Peoria, IL 61604-2803 | 2011-03-02 |
| 1356792956 | Jessica Gamblin | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2016-06-24 |
| 1285045013 | Melinda Lucille Lange | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-05-14 |
| 1679904858 | William Meyers II | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-12-12 |
| 1609211101 | Ruth Ann Arms | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-1726 | 2013-05-09 |
| 1902152077 | Linda Marie Cooper | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-07-26 |
| 1871865683 | Sarah L Lindsey | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2012-02-09 |
| 1104103670 | Jessica M Stewart | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2011-11-10 |
| 1124304407 | Melissa R Mcqueary | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2011-10-31 |
| Find all providers in PEORIA | ||||
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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.