REBECCA SUE HERROLD-ENGSTROM (NPI# 1518369883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518369883 |
| Entity Type | Individual |
| Full Name | REBECCA SUE HERROLD-ENGSTROM |
| Credential | MSN, FNP |
| Practice Address |
1101 Glendale Blvd Ste 103 Valparaiso IN 46383 |
| Mailing Address |
1101 Glendale Blvd Ste 103 Valparaiso IN 46383-3769 |
| Practice Telephone | 2194649054 |
| Practice Fax Number | 2194651749 |
| Mailing Telephone | 2194649054 |
| Mailing Fax Number | 2194651749 |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2018-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71005207A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
71005207A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 85 E Us Highway 6 Ste 235, Valparaiso, IN 463838948 | 2194949054 | 2194651749 |
| Street Address |
1101 GLENDALE BLVD STE 103 |
| City | VALPARAISO |
| State | IN |
| Zip Code | 46383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114588076 | Lindsey Leann Sample | Registered Nurse | 1101 Glendale Blvd Ste 103, Valparaiso, IN 46383-3769 | 2019-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962860 | Andrea Abbett | Pharmacist | 333 Boyd Blvd Laporte, In 46350, 211 S 75 E, Valparaiso, IN 46383 | 2020-11-03 |
| 1144868043 | Callan Gannon Jones | Registered Nurse | 83 E Us-6 Frontage Road, Valparaiso, IN 46383 | 2019-12-11 |
| 1972163806 | Melissa E Valtierra | Counselor | 204 Valparaiso St, Valparaiso, IN 46383 | 2019-06-13 |
| 1003472721 | Roman Podiatry Partners Inc | Podiatrist | 2308 N. Roosevelt, Valparaiso, IN 46383 | 2019-05-17 |
| 1831654680 | Mark Esiyeden | Driver | 1407 1/2 Chicago Street, 4, Valparaiso, IN 46383 | 2019-02-06 |
| 1770062663 | The Dialysis Center of Valparaiso LLC | Clinic/Center | 2711 Leonard Drive, Suite 100, Valparaiso, IN 46383 | 2018-08-10 |
| 1285112334 | Tricia Louise Burkins | Nurse Practitioner | 1861 South Sturdy Road, Valparaiso, IN 46383 | 2018-08-01 |
| 1598262388 | Elizabeth R Kozak | Physical Therapist | 2307 Laporte Ave Ste 5, Valparaiso, IN 46383 | 2018-04-09 |
| 1588160725 | Innovative Counseling Solutions LLC | Social Worker | 8 Morgan Street, Valparaiso, IN 46383 | 2018-04-05 |
| 1275034860 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 405 Porters Vale Boulevard, Valparaiso, IN 46383 | 2018-02-28 |
| Find all providers in zip 46383 | ||||
| Taxonomy Code | 363LC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770876542 | Mary Lou Snouffer | Nurse Practitioner | 1234 E Dupont Rd # Ppg, Fort Wayne, IN 46825-1545 | 2011-05-26 |
| 1578102950 | Leslie Bruchey | Nurse Practitioner | 8330 Naab Rd, Indianapolis, IN 46260-5925 | 2020-01-02 |
| 1073150918 | Katie Elizabeth Abney | Nurse Practitioner | 10590 N Meridian St Ste 105, Indianapolis, IN 46290-1028 | 2019-12-10 |
| 1629529334 | Tracy Kerzan | Nurse Practitioner | 520 S 7th St, Vincennes, IN 47591-1038 | 2016-10-18 |
| 1811348279 | Christopher Furrey | Nurse Practitioner | 1801 N Senate Blvd, Indianapolis, IN 46202-1228 | 2016-06-28 |
| 1770716599 | Dana M. Wisehart | Nurse Practitioner | 1800 N Capitol Ave, Rm. E140, Indianapolis, IN 46202-1218 | 2009-08-27 |
| 1124251160 | Lindsay T Anderson | Nurse Practitioner | 1801 N Senate Blvd., Suite 635, Indianapolis, IN 46202-1212 | 2009-08-25 |
| 1063565968 | Nicolas Alexander | Nurse Practitioner | 2001 W 86th St, 3rd Floor Medical Education Center, Indianapolis, IN 46260-1902 | 2007-01-22 |
| City | VALPARAISO |
| Zip Code | 46383 |
Please comment or provide details below to improve the information on REBECCA SUE HERROLD-ENGSTROM.
| 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.