LISA NANNIE (NPI# 1417962937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417962937 |
| Entity Type | Individual |
| Full Name | LISA NANNIE |
| Credential | FNP |
| Practice Address |
8914 N Knoxville Ave Peoria IL 61615-1410 |
| Mailing Address |
5100 Reliable Pkwy Chicago IL 60686-0001 |
| Practice Telephone | 3096919110 |
| Mailing Telephone | 3096724809 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | JOHN DEERE | IL01W1 | 01 |
| IL | HEALTH ALLIANCE | 050884 | 01 |
| IL | HEALTHLINK | 472307 | 01 |
| IL | BCBS PPO | 7215059 | 01 |
| Street Address |
8914 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-1410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588687800 | Jessica Higgs | Family Medicine | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2006-07-26 |
| 1578081790 | Laura Jarvis | Nurse Practitioner | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2017-09-08 |
| 1427584259 | Maria Meschewski | Nurse Practitioner | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2017-05-11 |
| 1588066427 | Tamra Joy Chan | Registered Nurse | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2014-09-23 |
| 1285640276 | Michael Johnson | Emergency Medicine | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2006-07-31 |
| 1962416966 | Lestel Escorcia | Family Medicine | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2006-07-28 |
| 1154335107 | Marianna Cuany | Family Medicine | 8914 N Knoxville Ave, Peoria, IL 61615-1410 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787072 | Brijeshaben Urvish Patel | Nurse Practitioner | 13300 N 88th Ave Apt 2007, Peoria, AZ 85381-2614 | 2020-07-10 |
| 1457906380 | Dana Putman | Nurse Practitioner | 26105 N 137th Ln, Peoria, AZ 85383-8080 | 2019-08-07 |
| 1255815858 | Karibu Family Care Pllc | Nurse Practitioner | 20542 N Lake Pleasant Rd Ste 105, Peoria, AZ 85382-9749 | 2018-09-19 |
| 1003170440 | Diana Sun Bone | Nurse Practitioner | 9947 West Happy Valley Parkway, # 104, Peoria, AZ 85383-6001 | 2012-06-29 |
| 1851333819 | Tina White | Nurse Practitioner | 1419 S Folkers Ave, Peoria, IL 61605-1356 | 2006-06-12 |
| 1457398265 | Cheryl Kliot-lape | Nurse Practitioner | 800 W Romeo B Garrett Ave, Peoria, IL 61605-2207 | 2006-06-01 |
| 1083263503 | Wellness for Life Family Practice | Nurse Practitioner | 20449 N Lake Pleasant Rd Ste 101, Peoria, AZ 85382-2707 | 2019-09-06 |
| 1366913618 | Krishna Keshav | Nurse Practitioner | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381 | 2018-12-16 |
| 1407223969 | Teresa Michelle Watts | Nurse Practitioner | 900 Main St, Suite 100, Peoria, IL 61602-1005 | 2015-08-31 |
| 1881912392 | Jailson Souza Nascimento | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2010-05-07 |
| 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.