LAURA SUE MCCLENNY (NPI# 1588987200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588987200 |
| Entity Type | Individual |
| Full Name | LAURA SUE MCCLENNY |
| Credential | NP |
| Practice Address |
3802 Manhatton Dr Tyler TX 75701-9451 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035098888 |
| Mailing Telephone | 9033246450 |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2014-10-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 669980 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TRICARE | TIN PLUS 020 | 01 |
| TX | 211234401 | 05 | |
| TX | TRICARE | 75-2616977-118 | 01 |
| TX | BCBS | 817N75 | 01 |
| TX | RAIL ROAD MEDICARE | P00820916 | 01 |
| Street Address |
3802 MANHATTON DR |
| City | TYLER |
| State | TX |
| Zip Code | 75701-9451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043284938 | James A Lively | Family Medicine | 3802 Manhatton Dr, Tyler, TX 75701-9451 | 2006-02-15 |
| 1083991160 | Brandi Lynn Cox | Nurse Practitioner | 3802 Manhatton Dr, Tyler, TX 75701-9451 | 2011-11-03 |
| 1255582086 | Trinity Clinic | Clinic/Center | 3802 Manhatton Dr, Tyler, TX 75701-9451 | 2008-10-10 |
| 1740439769 | Jason L Gipson | Family Medicine | 3802 Manhatton Dr, Tyler, TX 75701-9451 | 2008-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841830601 | David Clay Mcintyre | Nurse Practitioner | 7924 S Broadway Ave Ste 900, Tyler, TX 75703-5252 | 2020-01-09 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1477925600 | Brenda Leath Goings | Nurse Practitioner | 703 S Fleishel Ave # 5000, Tyler, TX 75701 | 2015-10-27 |
| 1750708368 | Crossway Family Health Center Pllc | Nurse Practitioner | 6004 South Broadway, Tyler, TX 75703-4424 | 2014-03-20 |
| 1780952580 | Loretta Eve Wilson | Nurse Practitioner | 700 Olympic Plaza Cir Ste 904, Tyler, TX 75701-1958 | 2011-12-07 |
| 1558442376 | Christina Danielle Barnes | Nurse Practitioner | 800 E Dawson St - Hospitalists, Tyler, TX 75701 | 2006-10-18 |
| 1164406773 | Gayle Pegler Varnell | Nurse Practitioner | 3900 University Blvd, Tyler, TX 75799-0001 | 2005-12-06 |
| 1922080076 | Kerry Scruggs | Nurse Practitioner | 3310 Patriot Dr, Tyler, TX 75701-6606 | 2005-11-15 |
| 1003414525 | Abram Ambriz | Nurse Practitioner | 2608 Mcdonald Rd, Tyler, TX 75701-5934 | 2020-10-16 |
| 1396350039 | Lorna Casey Blakney | Nurse Practitioner | 1305 Doctors Dr, Tyler, TX 75701-2263 | 2020-09-10 |
| Find all providers in TYLER | ||||
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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.