MS. THERESA LAURA MANTLE (NPI# 1760875124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760875124 |
Entity Type | Individual |
Full Name | MS. THERESA LAURA MANTLE |
Credential | ARNP |
Practice Address |
4930 E Lake Mary Blvd Sanford FL 32771-5003 |
Practice Telephone | 4073228645 |
Mailing Telephone | 4073228645 |
Enumeration Date | 2015-03-10 |
Last Update Date | 2017-02-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
ARNP1842852 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
4930 E LAKE MARY BLVD |
City | SANFORD |
State | FL |
Zip Code | 32771-5003 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912901497 | Hector Octaviani | Pediatrics | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2005-06-13 |
1093349433 | Marcell Bailey | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2020-02-25 |
1174157614 | Gloria Isabel Torrens | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2020-02-24 |
1720627300 | Wendy Joseph | Family Medicine | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2019-12-31 |
1942706585 | Allison Conley | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2018-04-03 |
1215435151 | Candace Folch | Physician Assistant | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2018-01-25 |
1083093355 | Kimcheree Jackson | Nurse Practitioner | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2015-05-20 |
1134514870 | Myra White | Advanced Practice Midwife | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2015-03-31 |
1700291176 | Luisa Ozema Mena | General Practice | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2014-06-24 |
1376953836 | Emma M Herrera | General Practice | 4930 E Lake Mary Blvd, Sanford, FL 32771-5003 | 2014-05-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134695224 | Sheena L Grayson | Pharmacist | 4942 W State Rd 46, Suite 1014, Sanford, FL 32771 | 2018-10-16 |
1699284299 | Christopher Ryan King | Chiropractor | 1026 Old England Loop, Sanford, FL 32771 | 2017-09-26 |
1669991345 | Scarlett Sierra | Counselor | 401 W Seminole Blvd, Sanford, FL 32771 | 2017-09-14 |
1881132249 | Tracy Shibla | Nurse Practitioner | 2320 Retreat View Cir, Sanford, FL 32771 | 2017-02-06 |
1205387206 | Tabitha Boyd | Behavior Technician | 4136 Geranium Ln #102, Sanford, FL 32771 | 2016-10-14 |
1104275874 | Jessica Willis | Nurse Anesthetist, Certified Registered | 108 Temple Dr, Sanford, FL 32771 | 2016-06-03 |
1013379957 | Bai Medical LLC | Point of Service | 580 Lexington Green Lane, Sanford, FL 32771 | 2016-03-21 |
1710347851 | Melissa T Ramsawak | Nurse Practitioner | 4930 East Lake Mary Boulevard, Sanford, FL 32771 | 2016-03-02 |
1811394570 | Tanesha Burns | Counselor | 209 San Carlos Ave Ste 111a, Sanford, FL 32771 | 2014-11-24 |
1053717322 | Amy Hertz, Dmd and Minta Lopez-torres, Dmd | Dentist | 5030 West Sr 46, Suite 1018, Sanford, FL 32771 | 2014-11-13 |
Find all providers in zip 32771 |
Taxonomy Code | 363LW0102X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Women's Health |
Definition to come... |
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1669411641 | Patricia A Fairall | Nurse Practitioner | 886 Main St, Sanford, ME 04073-7008 | 2006-06-06 |
1003051418 | Molly Jean Crossman | Nurse Practitioner | 1140 Carthage St, Sanford, NC 27330-4161 | 2008-12-15 |
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1861005464 | Sharon Resto | Nurse Practitioner | 16206 Breckinmore Ln, Tampa, FL 33625-1004 | 2020-08-25 |
1346863552 | Danielle Selig Jaeger | Nurse Practitioner | 27 Flowertree Dr, Ormond Beach, FL 32174-3091 | 2020-05-21 |
1568096550 | Denise Nicely | Nurse Practitioner | 5100 Station Way, Sarasota, FL 34233-3221 | 2020-02-27 |
1104450592 | Kionna Sadie Pitts | Nurse Practitioner | 2902 N Armenia Ave Ste 100, Tampa, FL 33607-1661 | 2020-02-25 |
1720610090 | Patricia Rivero | Nurse Practitioner | 445 Woodcrest Rd, Key Biscayne, FL 33149-1838 | 2020-02-05 |
1215567524 | Kristina Chardon | Nurse Practitioner | 11500 University Blvd Ste B, Orlando, FL 32817-2197 | 2020-01-26 |
1962043554 | Marcel Bernadette Nagel | Nurse Practitioner | 1523 Ashlee Branch Way, Saint Johns, FL 32259-1923 | 2019-10-04 |
1336798412 | Vicky Arlene Smith | Nurse Practitioner | 501 Pointe Allyson Way, Orlando, FL 32825-5973 | 2019-09-10 |
1003476011 | Angela Marie Bumpus | Nurse Practitioner | 9121 Lantern Oak Way, Land O Lakes, FL 34638-2607 | 2019-06-20 |
1396301230 | Mary Elizabeth Buie | Nurse Practitioner | 5457 Baldwin Park St, Orlando, FL 32814-6749 | 2019-05-16 |
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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.