ANGELICA CECILIA KJONNEROD (NPI# 1760754485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760754485 |
| Entity Type | Individual |
| Full Name | ANGELICA CECILIA KJONNEROD |
| Credential | PA |
| Practice Address |
192 Lindquist Road Bldg 412 Fort Stewart GA 31315 |
| Practice Telephone | 9124355453 |
| Practice Fax Number | 9124355674 |
| Mailing Telephone | 9124355453 |
| Mailing Fax Number | 9124355674 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
192 LINDQUIST ROAD BLDG 412 |
| City | FORT STEWART |
| State | GA |
| Zip Code | 31315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730500869 | Tracey Michelle Lyons-white | Physician Assistant | 192 Lindquist Road, Fort Stewart, GA 31314 | 2013-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588188791 | Nadia E Jeter | Social Worker | 140 Skyland Spruce Dr, Fort Stewart, GA 31315 | 2017-07-29 |
| 1740739358 | Graham Taylor | Physician Assistant | 8435 Vanguard Rd., Fort Stewart, GA 31315 | 2016-09-23 |
| 1205289865 | Glenda Ann Reed-withers | Dental Hygienist | 343 Warrior Road Building 2115, Fort Stewart, GA 31315 | 2016-07-19 |
| 1275940686 | Tarhonda Leah Ingram | Dentist | 112 Vilseck Road, Bldg. 419-2, Ft. Stewart, GA 31315 | 2014-07-17 |
| 1053668830 | Lee Joshua Martin | Dentist | 112 Vilseck Rd, Fort Stewart, GA 31315 | 2012-08-10 |
| 1497866248 | Henry J Braner | Physician Assistant | 16th Street Building 13514, Youth Challange Academy, Ft Stewart, GA 31315 | 2006-08-31 |
| 1215981352 | Harry Nick Bobotis | Dentist | 112 Vilseck Road, Bldg 419-2, Fort Stewart, GA 31315 | 2006-05-22 |
| 1033665393 | Christopher David Johnson | Specialist/Technologist, Other | 1061 Harmon Ave, Fort Stewart, GA 31315 | 2016-08-28 |
| 1760886410 | Juliann Roman | Emergency Medical Technician, Basic | 1061 Harmon Ave, Fort Stewart, GA 31315 | 2014-10-09 |
| 1932478047 | Sarah G Talone | Registered Nurse | 6 Red Bud Dr, Fort Stewart, GA 31315-1056 | 2011-12-19 |
| Find all providers in zip 31315 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902389588 | Bryan Anderson | Physician Assistant | 8435 Vanguard Road, Fort Stewart, GA 31324 | 2018-09-10 |
| 1740739358 | Graham Taylor | Physician Assistant | 8435 Vanguard Rd., Fort Stewart, GA 31315 | 2016-09-23 |
| 1831136597 | Lori Michele Smith | Physician Assistant | 1061 Harmon Ave Ste1003, Winn Army Community Hospital, Fort Stewart, GA 31314-5611 | 2006-06-01 |
| 1396738357 | Rosemarie Casanova | Physician Assistant | 1061 Harmon Ave Ste 1d06, Fort Stewart, GA 31314-5641 | 2005-08-25 |
| 1093715708 | Thomas Lee Ryan | Physician Assistant | 1061 Harmon Ave., Ste, Winn Army Community Hospital, Fort Stewart, GA 31314-5674 | 2005-07-22 |
| 1104452218 | Tiffany L Stark | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-20 |
| 1396371035 | Alicia Nichole Hasquin | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-13 |
| 1215579685 | Nicholas Vetollis Ruggieri | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2019-10-17 |
| 1356901797 | Ryan P Shannon | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2019-06-18 |
| 1124586581 | John Long | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2019-03-05 |
| Find all providers in FORT STEWART | ||||
| City | FORT STEWART |
| Zip Code | 31315 |
Please comment or provide details below to improve the information on ANGELICA CECILIA KJONNEROD.
| 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.