TEDRA E ESTIS (NPI# 1548612468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548612468 |
| Entity Type | Individual |
| Full Name | TEDRA E ESTIS |
| Credential | DNP, FPMHNP |
| Practice Address |
323 E Grand St Springfield MO 65807-1447 |
| Mailing Address |
1300 E Bradford Pkwy Springfield MO 65804-4264 |
| Practice Telephone | 4177615600 |
| Practice Fax Number | 4177615601 |
| Mailing Telephone | 4177615000 |
| Mailing Fax Number | 4177615065 |
| Enumeration Date | 2016-07-02 |
| Last Update Date | 2020-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2016006748 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 420034864 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 930 S Robberson Ave, Springfield, MO 658063220 | 4177615540 | |
| 323 E Grand St, Springfield, MO 658071447 | 4177615600 | 4177615601 |
| Street Address |
323 E GRAND ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144202912 | Erika L Crabtree | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2005-11-17 |
| 1104427624 | Lee Owen Cunningham | Pharmacist | 323 E Grand St, Springfield, MO 65807-1447 | 2020-11-02 |
| 1922513894 | Micah A Gillen | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2017-12-13 |
| 1194190066 | Burrell, Inc. | Pharmacy | 323 E Grand St, Springfield, MO 65807-1447 | 2015-12-03 |
| 1295113694 | Jeremy W Dickson | Counselor | 323 E Grand St, Springfield, MO 65807 | 2015-05-18 |
| 1396144051 | Tanya Rea Johnson | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2014-08-19 |
| 1730475666 | Susan Michelle Baker | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2011-06-20 |
| 1942523493 | Cristin R Martinez | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2010-03-11 |
| 1093848913 | Advocates for A Healthy Community, Inc | Clinic/Center | 323 E Grand St, Springfield, MO 65807-1447 | 2007-03-13 |
| 1588773477 | Advocates for A Healthy Community, Inc. | Clinic/Center | 323 E Grand St, Springfield, MO 65807-1447 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217873 | Ifeoma E Iherobiem | Nurse Practitioner | 884 S Springfield Ave Apt 18, Springfield, NJ 07081-3320 | 2020-08-28 |
| 1477178978 | Eric Avent | Nurse Practitioner | 111 5th Ave W Ste 103, Springfield, TN 37172-2428 | 2020-06-10 |
| 1043722770 | Mary Catherine Knutson | Nurse Practitioner | 1201 S 4th St, Springfield, IL 62703-2228 | 2017-11-03 |
| 1922422617 | Azuka Ofodike | Nurse Practitioner | 31 Tooker Pl, Springfield, NJ 07081-2227 | 2014-02-14 |
| 1306117189 | Mark Anthony Lynch | Nurse Practitioner | 7108 Neuman St, Springfield, VA 22150-4419 | 2012-01-25 |
| 1609100973 | Cindy Michael | Nurse Practitioner | 841 E Northern Ave, Springfield, OH 45503-3848 | 2009-09-18 |
| 1811097058 | Jain A Lattes | Nurse Practitioner | 3300 Main St Fl 4, Springfield, MA 01107-1112 | 2006-09-25 |
| 1174540504 | Johnson Komolafe | Nurse Practitioner | 7011 Calamo St, #105, Springfield, VA 22150 | 2006-07-15 |
| 1083648604 | Dawn M Vanderhoef | Nurse Practitioner | 713 Cheatham St, Springfield, TN 37172-2828 | 2006-07-10 |
| 1316992019 | Ruben Montanez | Nurse Practitioner | 1695 Main St Fl 400, Springfield, MA 01103-1063 | 2006-05-23 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
Please comment or provide details below to improve the information on TEDRA E ESTIS.
| 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.