GWENDOLYN SUE KRESOVSKY (NPI# 1649465410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649465410 |
| Entity Type | Individual |
| Full Name | GWENDOLYN SUE KRESOVSKY |
| Credential | NP-C |
| Practice Address |
3015 10th St Columbus IN 47201-7090 |
| Mailing Address |
Po Box 775383 Chicago IL 60677-5383 |
| Practice Telephone | 8123728426 |
| Practice Fax Number | 8123787777 |
| Mailing Telephone | 8123753000 |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
71002463A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201154020 | 05 | |
| IN | ANTHEM PIN | 000000986921 | 01 |
| Street Address |
3015 10TH ST |
| City | COLUMBUS |
| State | IN |
| Zip Code | 47201-7090 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417959917 | Sueann Thomas | Nurse Practitioner | 3015 10th St, Columbus, IN 47201-7090 | 2005-08-15 |
| 1376070847 | Janna Kasting Nickoll | Registered Nurse | 3015 10th St, Columbus, IN 47201-7090 | 2017-05-16 |
| 1114394541 | Danielle Hewitt | Audiologist | 3015 10th St, Columbus, IN 47201-6603 | 2015-09-02 |
| 1841667276 | Naine Dorthea Fiscus Sol | Audiologist | 3015 10th St, Columbus, IN 47201-6603 | 2015-09-02 |
| 1275811952 | Sivagama Valli Ramasundaram | Internal Medicine | 3015 10th St, Columbus, IN 47201-7090 | 2011-07-28 |
| 1346533700 | Kathleen Smith Md, LLC | Family Medicine | 3015 10th St, Columbus, IN 47201-6603 | 2011-05-18 |
| 1134206642 | Mary Beth Hensley | Family Medicine | 3015 10th St, Columbus, IN 47201-7090 | 2006-11-01 |
| 1841392883 | Kathleen Smith | Family Medicine | 3015 10th St, Columbus, IN 47201-7090 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389569 | Ryanne Nicole Slavens | Speech-Language Pathologist | 1974 Glenmoor Drive, Columbus, IN 47201 | 2020-09-08 |
| 1023670759 | Alisha Nicole Scoville | Counselor | 2630 22nd Street, Columbus, IN 47201 | 2019-07-02 |
| 1467964718 | Columbus Radiology Physicians LLC | Radiology | 2400 E. 17th Street, Columbus, IN 47201 | 2017-10-26 |
| 1790148849 | Gabriel Woon | Specialist | 913 25th St., Columbus, IN 47201 | 2016-04-05 |
| 1144680604 | Forefront Dermatology, S.c. | Dermatology | 244 Westwood Blvd, Columbus, IN 47201 | 2016-02-26 |
| 1871832550 | Jennifer Lynn Grant | Nurse Practitioner | 836 Jackson St., Columbus, IN 47201 | 2013-01-31 |
| 1235404526 | Eric Philip Tannenbaum | Orthopaedic Surgery | 940 N Marr Rd Ste C, Columbus, IN 47201 | 2012-03-20 |
| 1881994176 | Terri Ann Brewer | Social Worker | 12000 W. Moores Vineyard Rd, Columbus, IN 47201 | 2010-11-02 |
| 1255654620 | The Kane Group LLC | Durable Medical Equipment & Medical Supplies | 927 Fourth Street, Columbus, IN 47201 | 2010-03-12 |
| 1023243771 | Allison K Royer | Otolaryngology | 2326 18th Street, Suite 230, Columbus, IN 47201 | 2009-05-26 |
| Find all providers in zip 47201 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394235 | Lisa Ann Popovich | Nurse Practitioner | 3703 Canon Ridge Pl, Columbus, OH 43230-4010 | 2020-10-17 |
| 1548812159 | Holly Penix | Nurse Practitioner | 223 Bluewing Ct, Columbus, OH 43235-1490 | 2019-07-13 |
| 1558840496 | Sheila Parker Strickland | Nurse Practitioner | 7413 Whitesville Rd Ste 700, Columbus, GA 31904-3230 | 2018-08-11 |
| 1669992822 | Susan Lee Mcfall | Nurse Practitioner | 1258 Grandview Ave Ste A, Columbus, OH 43212-3469 | 2017-06-20 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1285095802 | Laura Aumiller | Nurse Practitioner | 842 Grandview Ave, Columbus, OH 43215-1124 | 2016-03-09 |
| 1457741498 | Roshann Palmer | Nurse Practitioner | 5151 Reed Rd Ste 205, Columbus, OH 43220-2553 | 2015-01-29 |
| 1548650617 | Katherine Marie Wallace | Nurse Practitioner | 118 Enterprise Ct Ste B, Columbus, GA 31904-9228 | 2015-01-28 |
| 1144637299 | Jody Anne Howell | Nurse Practitioner | 1391 W 5th Ave, Suite 260, Columbus, OH 43212-2902 | 2014-07-21 |
| 1538589536 | Courtney Dubois Shihabuddin | Nurse Practitioner | 750 E Long St Ste 3000, Columbus, OH 43203-1874 | 2014-04-17 |
| Find all providers in COLUMBUS | ||||
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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.