TARA MENDIETTA (NPI# 1467929083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467929083 |
| Entity Type | Individual |
| Full Name | TARA MENDIETTA |
| Credential | FNPC |
| Practice Address |
305 E 3rd St Alice TX 78332-4705 |
| Mailing Address |
Po Box 289 Alice TX 78333-0289 |
| Practice Telephone | 3616649353 |
| Practice Fax Number | 3616681630 |
| Mailing Telephone | 3616649353 |
| Mailing Fax Number | 3616681630 |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP139592 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
305 E 3RD ST |
| City | ALICE |
| State | TX |
| Zip Code | 78332-4705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083707012 | Erik Nisimblat | Pediatrics | 305 E 3rd St, Alice, TX 78332 | 2006-10-02 |
| 1659660280 | Ramona Davila Garica | Nurse Practitioner | 305 E 3rd St, Alice, TX 78332-4705 | 2011-04-05 |
| 1023250891 | Colleen S. Carrell | Nurse Practitioner | 305 E 3rd St, Alice, TX 78332-4705 | 2009-03-25 |
| 1700979739 | William Nisimblat | Pediatrics | 305 E 3rd St, Alice, TX 78332-4705 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023650835 | Kimberly Ann Charles | Physical Therapy Assistant | 219 N.king St., Alice, TX 78332 | 2019-10-14 |
| 1679058457 | Edison Woods Hubert Jr. | Occupational Therapy Assistant | 608 Coyote Trail, Alice, TX 78332 | 2018-09-27 |
| 1417439662 | Trevor Stewart | Occupational Therapy Assistant | 1913 Olmos Ave, Alice, TX 78332 | 2018-09-04 |
| 1427535624 | The Premier Snf of Alice, LLC | Skilled Nursing Facility | 800-a Coyote Trail, Alice, TX 78332 | 2018-07-20 |
| 1730666959 | The Premier Memory Care of Alice, LLC | Assisted Living Facility | 800-b Coyote Trail, Alice, TX 78332 | 2018-07-20 |
| 1649757899 | The Premier Assisted Living of Alice, LLC | Assisted Living Facility | 800-c Coyote Trail, Alice, TX 78332 | 2018-07-20 |
| 1689179087 | Hope Abrego | Nurse Practitioner | 2500 E Main St Fl 3, Alice, TX 78332 | 2018-03-27 |
| 1588183057 | Rural Economic Assistance League, Inc. | Secured Medical Transport (VAN) | 301 Lucero Street, Alice, TX 78332 | 2017-09-15 |
| 1083063234 | Vital Medcare Supply & Equipment, LLC | Durable Medical Equipment & Medical Supplies | 700 East Main Street, Alice, TX 78332 | 2016-06-08 |
| 1669842548 | Misscel's Home Healthcare LLC | In Home Supportive Care | 932 Mcmasters Rd., Alice, TX 78332 | 2015-10-05 |
| Find all providers in zip 78332 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405533 | Kimberly Dennise Gonzalez | Nurse Practitioner | 433 County Road 133, Alice, TX 78332-9365 | 2020-10-24 |
| 1689179087 | Hope Abrego | Nurse Practitioner | 2500 E Main St Fl 3, Alice, TX 78332 | 2018-03-27 |
| 1215459565 | Ricardo J Requenez | Nurse Practitioner | 2510 E Main St Ste 102, Alice, TX 78332-4188 | 2017-07-07 |
| 1124330360 | Lola Dina Reyna | Nurse Practitioner | 1707 Roosevelt Blvd, Alice, TX 78332-4027 | 2010-07-03 |
| 1255986204 | David Aaron Guerra | Nurse Practitioner | 317 E 1st St, Alice, TX 78332-4836 | 2019-08-06 |
| 1558846113 | Micah Labbe | Nurse Practitioner | 204 E 1st St, Alice, TX 78332-4822 | 2018-09-30 |
| 1811471402 | Jenna Kueker | Nurse Practitioner | 2510 E Main St Ste 102, Alice, TX 78332-4188 | 2018-09-19 |
| 1013424720 | Debra Kaye Alvarado | Nurse Practitioner | 779 N Texas Blvd, Alice, TX 78332-3883 | 2018-01-03 |
| 1023524089 | Dovie Stewart | Nurse Practitioner | 779 N Texas Blvd, Alice, TX 78332-3883 | 2017-12-28 |
| 1144622333 | Kristen Sosa | Nurse Practitioner | 2510 E Main St, Suite 106, Alice, TX 78332-4187 | 2014-09-19 |
| Find all providers in ALICE | ||||
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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.