SHELLEY WALDROP (NPI# 1457844284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457844284 |
| Entity Type | Individual |
| Full Name | SHELLEY WALDROP |
| Credential | RN |
| Practice Address |
2471 Centennial Dr Washington IL 61571-1066 |
| Mailing Address |
1404 W Clarewood Ave Peoria IL 61614-5816 |
| Practice Telephone | 3097179197 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WH0200X |
Registered Nurse Specialization: Home Health |
041.159658 | IL | Nursing Service Providers |
| Y | 163WH0200X |
Registered Nurse Specialization: Home Health |
041159658 | IL | Nursing Service Providers |
| Street Address |
2471 CENTENNIAL DR |
| City | WASHINGTON |
| State | IL |
| Zip Code | 61571-1066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144887290 | Cassandra Mccoy | Registered Nurse | 2471 Centennial Dr, Washington, IL 61571-1066 | 2019-05-23 |
| 1770051542 | Anne Marie Schaidle | Registered Nurse | 2471 Centennial Dr, Washington, IL 61571-1066 | 2018-11-09 |
| 1568939601 | Lisa House/apartment Byard | Registered Nurse | 2471 Centennial Dr, Washington, IL 61571-1066 | 2018-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904504 | Kelly Hornberger | Physical Therapist | 1201 Newcastle Rd., Washington, IL 61571 | 2018-09-01 |
| 1073050407 | Jillyn Cross | Occupational Therapist | 14 Oxford Court, Washington, IL 61571 | 2017-01-24 |
| 1639410772 | Stephen L Dejaynes | Counselor | 100 Hillcrest Drive, Washington, IL 61571 | 2013-03-14 |
| 1184998692 | One Counseling and Wellness | Counselor | 1003 North Cummings Lane, Washington, IL 61571 | 2012-03-01 |
| 1871878371 | M Lisa Kim | Pharmacist | 1700 Saddleridge Ct, Washington, IL 61571 | 2011-10-15 |
| 1073805156 | Skill Sprout International | Behavioral Analyst | 102 Walnut Street, Washington, IL 61571 | 2011-05-09 |
| 1659600948 | Skill Sprout, LLC | Behavioral Analyst | 128 Washington Square, Washington, IL 61571 | 2009-12-15 |
| 1700024916 | Julie Adams | Developmental Therapist | 700 S. Elm, Washington, IL 61571 | 2009-01-26 |
| 1851595128 | Michael John Herman | Dentist | 106 So Cummings Lane, Washington, IL 61571 | 2007-06-12 |
| 1861539132 | Gary Lee Cunningham | Dentist | 5 Laurel Ct., Washington, IL 61571 | 2007-01-30 |
| Find all providers in zip 61571 | ||||
| Taxonomy Code | 163WH0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Home Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679190706 | Chuks G Eziefula | Registered Nurse | 4931 N Capitol St Ne Apt 31, Washington, DC 20011-6752 | 2020-07-06 |
| 1265057681 | Chajuana Leola Payne | Registered Nurse | 1623 1st St Nw # A, Washington, DC 20001-1101 | 2020-06-11 |
| 1104456870 | Allen Latee Lancaster | Registered Nurse | 3523 Jay St Ne Apt 101, Washington, DC 20019-1647 | 2020-01-22 |
| 1881224590 | Alexis L Lancaster | Registered Nurse | 3712 Hayes St Ne Apt 102, Washington, DC 20019-1707 | 2020-01-22 |
| 1336783117 | Rayne Gibson | Registered Nurse | 223 Atlantic St Se, Washington, DC 20032-3043 | 2019-11-04 |
| 1043789191 | Jada Smith | Registered Nurse | 50 F St Nw Ste 3000, Washington, DC 20001-1530 | 2018-11-19 |
| 1902389141 | Ulanda Elbeth Snowden | Registered Nurse | 2304 Hartford St Se Apt 303, Washington, DC 20020-7964 | 2018-09-13 |
| 1265912596 | Daniel Antonio Carrillo | Registered Nurse | 3219 6th St Nw, Washington, DC 20010-2509 | 2018-08-16 |
| 1194203679 | Joshua Kenner | Registered Nurse | 1251 U St Se, Washington, DC 20020-7011 | 2018-08-06 |
| 1528554318 | Mary Singleton | Registered Nurse | 5 Rhode Island Ave Ne, Washington, DC 20002-1307 | 2018-07-05 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 61571 |
Please comment or provide details below to improve the information on SHELLEY WALDROP.
| 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.