CLARISSA RENO (NPI# 1619476504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619476504 |
| Entity Type | Individual |
| Full Name | CLARISSA RENO |
| Other Name | CLARISSA BURTON |
| Credential | FNP-C |
| Practice Address |
559 Vincent St Peterson Afb CO 80914-1541 |
| Mailing Address |
2620 Elm Hill Pike Nashville TN 37214-3108 |
| Practice Telephone | 7195560865 |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2019-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 1652933 | CO | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN.0993700-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3620 Austin Bluffs Pkwy, Colorado Springs, CO 809186631 | 7193250342 |
| Street Address |
559 VINCENT ST |
| City | PETERSON AFB |
| State | CO |
| Zip Code | 80914-1541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891797080 | Keith Andrew Baker | Family Medicine | 559 Vincent St, 21 Mdos/sgof -fam Hlth, Peterson Afb, CO 80914-1540 | 2005-06-01 |
| 1912475740 | Julian G Fiorina | Family Medicine | 559 Vincent St, Peterson Afb, CO 80914-1541 | 2018-11-09 |
| 1740776970 | Chelsea M. Cruz | Nurse Practitioner | 559 Vincent St, Peterson Afb, CO 80914-1541 | 2018-07-11 |
| 1376036665 | Emillie Claire Brandt | Dentist | 559 Vincent St, Peterson Afb, CO 80914-1541 | 2018-06-11 |
| 1164911053 | Renee Antoinette Smith | Dentist | 559 Vincent St, Peterson Afb, CO 80914-1540 | 2018-05-07 |
| 1720582448 | Cristina Cosner | Military Health Care Provider | 559 Vincent St, Attn: 21 Mdos/sgof - Flight Med, Peterson Afb, CO 80914-1540 | 2018-03-19 |
| 1891159463 | Tialicka Burgos Johnson | Registered Nurse | 559 Vincent St, Attn: 21 Mdos/sgog - Women's Health, Peterson Afb, CO 80914-1540 | 2016-04-11 |
| 1114385747 | Jeffrey A Turner | Physical Therapist | 559 Vincent St, Attn: 21 Mdos/sgoy - Physical Therapy, Peterson Afb, CO 80914-1540 | 2016-02-10 |
| 1689046500 | Christine Chanmyaethu Tun | Physician Assistant | 559 Vincent St, Attn: 21 Mods/sgof - Family Health, Peterson Afb, CO 80914-1540 | 2015-10-30 |
| 1023489556 | Elizabeth Bator | Nurse Practitioner | 559 Vincent St, Attn: 21 Mdos/sgof - Family Practice, Peterson Afb, CO 80914-1540 | 2015-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897250 | Kym Littlefield Whitaker | Nurse Practitioner | 110 Ent Avenue, Peterson Afb, CA 80914 | 2016-08-30 |
| 1114322583 | Jessica Charmaine Johnson | Social Worker | 559 Vincent St, Bldg 959, Attn: 21 Omrs/sgow, Peterson Afb, CO 80914 | 2014-10-28 |
| 1306916267 | John Frank Drozd | Psychologist | 21st Medical Group, 559 Vincent Street, Peterson Afb, CO 80914 | 2006-11-08 |
| 1801858865 | Moshe Mark Douglas Wexler | Clinical Neuropsychologist | 110 W. Ent Ave. Bldg 725, 21 Mdos/sgoh, Pafb, CO 80914 | 2006-04-05 |
| 1215902002 | William J Dickson | Dentist | Peterson Afb, Bld 950, Colorado Springs, CO 80914 | 2006-02-23 |
| 1740889773 | Brandon Dean Estes | Dental Hygienist | 1055 Stewart Ave, Bldg 2018, Apo, AA 80914 | 2020-10-21 |
| 1225458789 | Brianna Mcmurray | Family Medicine | 559 Vincent St Bldg 959, Colorado Springs, CO 80914 | 2014-04-23 |
| 1720406796 | Beth D Achterhoff | Physical Therapist | 559 Vincent St Bldg 959, Peterson Afb, CO 80914 | 2014-04-07 |
| 1275712895 | Monica Ibarra | Counselor | 559 Vincent St., Attn: 21 Mdos/sgow - Family Advocacy, Peterson Afb, CO 80914 | 2007-10-31 |
| 1912258591 | Ruth Angela Monsanto-williams | Nurse Practitioner | 110 West Ent Ave, Peterson Afb, 21st Medical Group, Colorado Springs, CO 80914-1540 | 2012-09-24 |
| Find all providers in zip 80914 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356897250 | Kym Littlefield Whitaker | Nurse Practitioner | 110 Ent Avenue, Peterson Afb, CA 80914 | 2016-08-30 |
| 1598906992 | Michele Lorraine Wolf | Nurse Practitioner | 599 Vincent Street, Attn: 21 Mdos/sgof-family Practice, Peterson Afb, CO 80914-1540 | 2009-03-13 |
| 1023489556 | Elizabeth Bator | Nurse Practitioner | 559 Vincent St, Attn: 21 Mdos/sgof - Family Practice, Peterson Afb, CO 80914-1540 | 2015-10-09 |
| 1275873556 | Edith Marie Reichert | Nurse Practitioner | 559 Vincent St Bldg 959, Peterson Afb, CO 80914-1541 | 2013-02-22 |
| 1013252980 | Jason F Blair | Nurse Practitioner | 559 Vincent St, Attn: 21mdos/sgof- Family Practice, Peterson Afb, CO 80914-1540 | 2012-12-04 |
| 1245329846 | Erin Peterson | Nurse Practitioner | 559 Vincent Street, Attn: 21 Mdos/sgof - Family Practice, Peterson Afb, CO 80914-1540 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619715 | Jonathan Thomas | Nurse Practitioner | 1419 Flannagan Ct, Erie, CO 80516-6941 | 2020-11-08 |
| 1013517879 | Melanie Bjorkman | Nurse Practitioner | 8316 Needle Drop Ct, Colorado Springs, CO 80908-1337 | 2020-10-29 |
| 1508466855 | Cassandra Elizabeth Saad | Nurse Practitioner | 4024 S Rifle Way, Aurora, CO 80013-3240 | 2020-10-27 |
| 1992304471 | Amanda Michelle Heibult | Nurse Practitioner | 22047 E Ridge Trail Dr, Aurora, CO 80016-2668 | 2020-10-26 |
| 1407455157 | Faith Emma Olson | Nurse Practitioner | 2550 Winding River Dr Unit C1, Broomfield, CO 80023-6545 | 2020-10-23 |
| 1932708872 | Carla E Paredes Diaz | Nurse Practitioner | 2215 South Dr, Pueblo, CO 81008-1755 | 2020-10-21 |
| 1932708013 | Lindsay Sweetman | Nurse Practitioner | 3575 Rocky Knoll Dr, Colorado Springs, CO 80920-4219 | 2020-10-20 |
| 1902405038 | Rosalind Daninger | Nurse Practitioner | 1390 S Potomac St Ste 128, Aurora, CO 80012-4529 | 2020-10-20 |
| 1548869860 | Colleen R Newvine | Nurse Practitioner | 2831 W 133rd Ave, Broomfield, CO 80020-5263 | 2020-10-19 |
| 1598364952 | Shannon Elena Mckenna | Nurse Practitioner | 3047 Lawrence St, Denver, CO 80205-2317 | 2020-10-17 |
| Find all providers with the same taxonomy | ||||
| City | PETERSON AFB |
| Zip Code | 80914 |
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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.