PRUDENCE LOGAN (NPI# 1457658288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457658288 |
| Entity Type | Individual |
| Full Name | PRUDENCE LOGAN |
| Credential | ST |
| Practice Address |
112 Boeykens Pl Ste 2a Normal IL 61761-2152 |
| Practice Telephone | 3098464716 |
| Practice Fax Number | 3094547348 |
| Mailing Telephone | 3098464716 |
| Mailing Fax Number | 3094547348 |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-02-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZS0410X |
Specialist/Technologist, Other Specialization: Surgical Technologist |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
112 BOEYKENS PL STE 2A |
| City | NORMAL |
| State | IL |
| Zip Code | 61761-2152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770887887 | Marlon Minor | Specialist/Technologist, Other | 112 Boeykens Pl Ste 2a, Normal, IL 61761-2152 | 2011-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1679108971 | Krystal Halliday | Occupational Therapist | 1815 N Towanda Barnes Rd, Normal, IL 61761 | 2020-03-06 |
| 1265915474 | Laine E Burek | Nurse Practitioner | 1765 Bradford Ln., Normal, IL 61761 | 2018-09-13 |
| 1801389986 | Ashley Michelle James | Specialist/Technologist | 347 S. University St, Normal, IL 61761 | 2018-06-12 |
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1497275069 | Mclean County Nursing Home | Non-emergency Medical Transport (VAN) | 901 N. Main St, Normal, IL 61761 | 2017-06-23 |
| 1235673666 | Megan Threm | Registered Nurse | 900 Franklin Ave Community Health Care Clinic, Normal, IL 61761 | 2016-12-04 |
| 1437513553 | Tiesha Smith | Specialist | 1800 Rockingham Dr, Apt 1d, Normal, IL 61761 | 2016-04-06 |
| 1285031658 | New Day Recovery | Community/Behavioral Health | 402 Summit, Normal, IL 61761 | 2014-12-01 |
| 1174927701 | Alyssa Marie Bruck | Occupational Therapist | 700 N Walnut St, Normal, IL 61761 | 2014-10-10 |
| Find all providers in zip 61761 | ||||
| Taxonomy Code | 246ZS0410X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Technologist |
| Surgical technologists are allied health professionals, who are an integral part of the team of medical practitioners providing surgical care to patients. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. |
| Notes: Source: Association of Surgical Technologists, "Job Description: Surgical Technologist," 2014. [7/1/2014: code modified, title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447750708 | Shelley R. Ruch | Specialist/Technologist, Other | 1604 Visa Drive, Ste 1, Normal, IL 61761 | 2018-02-13 |
| 1407107931 | Jamie D Peterson | Specialist/Technologist, Other | 1604 Visa Dr Ste 2, Normal, IL 61761-2195 | 2012-09-24 |
| 1700327228 | Ashleigh Thompson | Specialist/Technologist, Other | 1604 Visa Dr., Ste. 1, Normal, IL 61761 | 2017-03-16 |
| 1134678790 | Michael Hansen | Specialist/Technologist, Other | 1604 Visa Dr, Ste 1, Normal, IL 61761 | 2016-09-23 |
| 1578928784 | Mackenzie Knabe | Specialist/Technologist, Other | 1604 Visa Dr Ste 2, Normal, IL 61761-2195 | 2015-12-15 |
| 1639567902 | Stephanie Jo Layne | Specialist/Technologist, Other | 1604 Visa Dr., Ste. 2, Normal, IL 61761 | 2015-01-08 |
| 1962821116 | Jodi L Chamness | Specialist/Technologist, Other | 1604 Visa Dr., Ste. 2, Normal, IL 61761 | 2014-04-15 |
| 1144649740 | Michele R Murray | Specialist/Technologist, Other | 1604 Visa Dr., Ste 2, Normal, IL 61761 | 2014-04-10 |
| 1194141036 | Susan Moreau | Specialist/Technologist, Other | 1604 Visa Dr., Ste 2, Normal, IL 61761 | 2014-03-17 |
| 1003249996 | Ivy Megan Paige | Specialist/Technologist, Other | 1604 Visa Dr, Ste. 2, Normal, IL 61761-2195 | 2013-08-14 |
| Find all providers in NORMAL | ||||
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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.