KRISTIE TIDRICK (NPI# 1427521814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427521814 |
| Entity Type | Individual |
| Full Name | KRISTIE TIDRICK |
| Credential | RN |
| Practice Address |
1 Walter Scholer Dr Lafayette IN 47909-6303 |
| Mailing Address |
Po Box 5545 Lafayette IN 47903-5545 |
| Practice Telephone | 7654488000 |
| Mailing Telephone | 7654488000 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 28210200A | IN | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
PENDING | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM PIN NUMBER | PENDING | 01 |
| IN | PENDING | 05 |
| Street Address |
1 WALTER SCHOLER DR |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47909-6303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972585131 | Philip E Keller | Family Medicine | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2005-11-15 |
| 1659838464 | Christine A Hickey | Registered Nurse | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2019-02-28 |
| 1609225580 | Lauren N. Sallese | Registered Nurse | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2016-06-10 |
| 1356705313 | Sonya Janssen-luper | Social Worker | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2016-04-06 |
| 1578988440 | Melissa Kaye Kovich | Registered Nurse | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2014-02-28 |
| 1083054696 | Nanette R Julian | Nurse Practitioner | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2013-06-27 |
| 1902192776 | Kimberly Rogers | Registered Nurse | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2011-06-21 |
| 1457660235 | Nasreen Haq | Internal Medicine | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2010-09-28 |
| 1902125503 | Ingrid Bocanegra | Family Medicine | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2010-05-20 |
| 1104086958 | Jeffrey Wang | Family Medicine | 1 Walter Scholer Dr, Lafayette, IN 47909-6303 | 2008-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285135244 | Glasswater Creek of Lafayette, LLC | Assisted Living Facility | 208 Beck Ln, Lafayette, IN 47909 | 2018-02-26 |
| 1518418680 | Dental Professionals of Indiana, PC | Dentist | 2000 Veterans Memorial Parkway S, Lafayette, IN 47909 | 2016-10-24 |
| 1013394709 | Todd Hardin | Dentist | 2 Walter Scholer Drive, Lafayette, IN 47909 | 2015-05-01 |
| 1801296967 | Lacey Hintz | Occupational Therapy Assistant | 2308 Edgelea Dr, Lafayette, IN 47909 | 2014-08-26 |
| 1457691180 | Alicia A Duncan | Lactation Consultant, Non-RN | 207 Buckingham Drive, Lafayette, IN 47909 | 2013-02-16 |
| 1558646505 | Tammie Anne Shockley | Pharmacist | 2800 Old Us 231 S, Walgreens 10974, Lafayette, IN 47909 | 2011-10-20 |
| 1952553448 | Regina R Pilotte | Occupational Therapist | 3864 East 500 South, Lafayette, IN 47909 | 2008-10-16 |
| 1811182405 | Assisted Living Concepts Inc | Assisted Living Facility | 167 West 240 South, Lafayette, IN 47909 | 2007-09-07 |
| 1073716585 | Julia Ann Dillon | Counselor | 3554 Promenade Pkwy Ste E, Lafayette, IN 47909 | 2007-06-11 |
| 1639291503 | Winifred A. Landis | Pharmacist | 2806 Us 231 South, Lafayette, IN 47909 | 2007-04-04 |
| Find all providers in zip 47909 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and 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 |
|---|---|---|---|---|
| 1760089445 | Mara Nicole Humberg | Registered Nurse | 4293 Fletcher Dr, Lafayette, IN 47909-8401 | 2020-10-06 |
| 1932716156 | Cassie Renee Meynard | Registered Nurse | 1100 Bertrand Dr # A, Lafayette, LA 70506-4110 | 2020-10-01 |
| 1336753185 | Mary Elizabeth Wagner | Registered Nurse | 1804 Connemara Ln, Lafayette, IN 47905-7935 | 2020-08-31 |
| 1942831318 | Tera May Hornbeck | Registered Nurse | 2274 Flowering Crab Dr E, Lafayette, IN 47905-7729 | 2020-02-03 |
| 1417434416 | Mary E Hammack | Registered Nurse | 2770 Arapahoe Rd Ste 132-221, Lafayette, CO 80026-8018 | 2018-07-23 |
| 1285139949 | Kelly Lanigan | Registered Nurse | 825 Kaliste Saloom Rd Brandywine 3 Suite 100, Lafayette, LA 70508-2837 | 2018-03-26 |
| 1275076911 | Julie House-rhoda | Registered Nurse | 1501 Seneca Cir, Lafayette, CO 80026-1324 | 2016-11-29 |
| 1477000339 | Aimee Voiselle | Registered Nurse | Provider Health Services, 1509 Dulles Dr, Lafayette, LA 70506 | 2016-09-07 |
| 1396292645 | Catherine E Fenner | Registered Nurse | 2512 Cowley Dr, Lafayette, CO 80026-9172 | 2016-09-03 |
| 1396299475 | Terri Duplichan | Registered Nurse | 110 Hidden Acres Dr, Apt. C, Lafayette, LA 70503-6170 | 2016-08-07 |
| Find all providers in LAFAYETTE | ||||
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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.