TERESA ANNE DISTLER (NPI# 1679024798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679024798 |
Entity Type | Individual |
Full Name | TERESA ANNE DISTLER |
Credential | NP-C |
Practice Address |
12103 County Line Rd Russellville MO 65074-2814 |
Practice Telephone | 5736906271 |
Mailing Telephone | 5736906271 |
Enumeration Date | 2016-10-24 |
Last Update Date | 2016-10-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2016037029 | MO | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
12103 COUNTY LINE RD |
City | RUSSELLVILLE |
State | MO |
Zip Code | 65074-2814 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366716854 | Susan Elizabeth Wilson | Midwife | 5410 Hill Crest St, Russellville, MO 65074-1213 | 2012-02-29 |
1790940450 | Michelle Marie Ford | Local Education Agency (LEA) | 13111 Park St, Russellville, MO 65074-1232 | 2008-07-22 |
1205081361 | Kristen M Behrns | Speech-Language Pathologist | 13111 Park St, Russellville, MO 65074-1232 | 2008-11-17 |
1104078245 | Cole County R-i School District | Local Education Agency (LEA) | 13111 Park St, Russellville, MO 65074-1232 | 2008-10-21 |
1902420995 | Jessica Marie Keeran | Speech-Language Pathologist | 13600 Route C, Russellville, MO 65074-2033 | 2020-06-04 |
1952738510 | Outreach Support Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5014 Route D, Russellville, MO 65074-2244 | 2013-09-27 |
1699924993 | Betty Lou Scrivner | Nurse Practitioner | 14307 Route A, Russellville, MO 65074-2782 | 2008-09-11 |
1932436540 | Clean Air Unlimited, Inc. | Durable Medical Equipment & Medical Supplies | 59289 Prairie Hill Rd, Russellville, MO 65074-3142 | 2009-11-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962002782 | Randy Paul Stayton | Pharmacist | 2109 W Main, Russellville, AR 72801 | 2020-10-30 |
1881293975 | Jeana Corleen Anderson | Massage Therapist | 2621 W Main St Ste 9, Russellville, AR 72801-2551 | 2020-10-20 |
1437761806 | Sarah Alain Gumm | Social Worker | 701 E Main St Ste 11, Russellville, AR 72801-5209 | 2020-08-18 |
1922625755 | Mackenzie Skelton | Occupational Therapy Assistant | 300 W 21st St, Russellville, AR 72801-7321 | 2020-06-27 |
1902420995 | Jessica Marie Keeran | Speech-Language Pathologist | 13600 Route C, Russellville, MO 65074-2033 | 2020-06-04 |
1083238141 | Dr R Anesthesia & Pain Management Pa | Pain Medicine | 1660 West C Place, Russellville, AR 72801-2705 | 2020-06-04 |
1821610171 | Courageous Journey Psychological Services, LLC | Clinic/Center | 168 Bluefish Ave, Russellville, AR 72802-2407 | 2020-05-09 |
1356975890 | William John Cobb | Pharmacist | 108 Skyline Dr Ste B, Russellville, AR 72801-3306 | 2020-02-24 |
1316587850 | Friends of Freedom House Inc. | Counselor | 404 Lake Front Drive, Russellville, AR 72802 | 2020-01-13 |
1679113583 | Dm Parks Inc., Dba Comfort Keepers | In Home Supportive Care | 5068 N Arkansas Ave, Russellville, AR 72802-8325 | 2020-01-08 |
Find all providers in RUSSELLVILLE |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104471911 | Lashawnda Lee | Nurse Practitioner | 60 Shelton Lane, Russellville, KY 42276 | 2019-08-08 |
1649731829 | Haley Shaleigh Knight | Nurse Practitioner | 15225 Highway 43 Ste I, Russellville, AL 35653-1969 | 2019-03-28 |
1427516418 | Hanna Helich Henderson | Nurse Practitioner | 1040 Beth Dr, Russellville, TN 37860-8985 | 2019-03-08 |
1669979530 | Robin Lenora Franke | Nurse Practitioner | 3127 W 2nd Ct Ste B, Russellville, AR 72801-4566 | 2018-04-09 |
1487003364 | Robert Barnowsky | Nurse Practitioner | 101 James N Hovater Rd, Russellville, AL 35653-0626 | 2016-06-10 |
1457706012 | Sarah Baxley | Nurse Practitioner | 106 Weir Rd, Ste 4, Russellville, AR 72802-9445 | 2016-05-02 |
1720385545 | Robin Michelle Joslin | Nurse Practitioner | 1605 Coliseuam Drive Doc Bryan Building, Suite 119, Russellville, AR 72801 | 2011-02-14 |
1710116066 | Family Medical Clinic LLC | Nurse Practitioner | 1355 George Wallace Hwy, Russellville, AL 35654-3281 | 2009-07-08 |
1821245069 | Agalia Renea Baker | Nurse Practitioner | 350 Walleye Dr, Russellville, AR 72802-7282 | 2008-08-19 |
1851473102 | Melanie Brianne Malone | Nurse Practitioner | 15225 Highway 43 Ste G, Russellville, AL 35653-1969 | 2006-10-19 |
Find all providers in RUSSELLVILLE |
City | RUSSELLVILLE |
Zip Code | 65074 |
Please comment or provide details below to improve the information on TERESA ANNE DISTLER.
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.