MRS. ELLEN LAVERA QUALLS (NPI# 1689819682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689819682 |
| Entity Type | Individual |
| Full Name | MRS. ELLEN LAVERA QUALLS |
| Credential | APN |
| Practice Address |
225 East Jaskson Street Jonesboror AR 72401-7302 |
| Mailing Address |
225 E Jackson Ave Jonesboro AR 72401-3119 |
| Practice Telephone | 8702077630 |
| Practice Fax Number | 8702076581 |
| Mailing Telephone | 8702071630 |
| Mailing Fax Number | 8702076581 |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2013-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2100X |
Clinical Nurse Specialist Specialization: Acute Care |
A03179 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BCBS | 5R233 | 01 |
| AR | APN LICENSE A03179 | A03179 | 01 |
| AR | 180502758 | 05 |
| Street Address |
225 EAST JASKSON STREET |
| City | JONESBOROR |
| State | AR |
| Zip Code | 72401-7302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 364SA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619306537 | Venecia M. Johnson | Clinical Nurse Specialist | 5700 West Markham Street, Little Rock, AR 72205 | 2013-11-01 |
| 1003976275 | Lucy R Wisemon | Clinical Nurse Specialist | 4301 West 7th, Little Rock, AR 72205 | 2006-12-11 |
| 1316466154 | Rachel Cohen | Clinical Nurse Specialist | 201 E Oak Ave, Jonesboro, AR 72401-4163 | 2017-09-13 |
| 1255853503 | Ashley James; Dnp, Aprn | Clinical Nurse Specialist | 1400 W 43rd Ave, Pine Bluff, AR 71603-7010 | 2017-07-07 |
| 1144771296 | Kayla Beth Ingram-smith | Clinical Nurse Specialist | 10100 Kanis Rd, Little Rock, AR 72205-6202 | 2016-10-24 |
| 1689026726 | Claudia Barone | Clinical Nurse Specialist | 4301 W Markham St, Slot 529, Little Rock, AR 72205-7101 | 2016-07-12 |
| 1124119094 | Margaret Justus | Clinical Nurse Specialist | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2006-09-27 |
| City | JONESBOROR |
| Zip Code | 72401 |
Please comment or provide details below to improve the information on MRS. ELLEN LAVERA QUALLS.
| 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.