AMELIA L PAULEY


Address: 101 Industry Rd, Bridgeport, IL 62417-2442
Phone: 6189453001

AMELIA L PAULEY (NPI# 1760973424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760973424
Entity Type Individual
Full Name AMELIA L PAULEY
Other Name AMELIA L MCCLURE
Credential PMHNP
Practice Address 101 Industry Rd
Bridgeport
IL 62417-2442
Mailing Address 800 E Locust St
Olney
IL 62450-2553
Practice Telephone 6189453001
Practice Fax Number 6189453005
Mailing Telephone 6183957340
Mailing Fax Number 6183923228
Enumeration Date 2018-05-29
Last Update Date 2019-08-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 28191422A IN Nursing Service Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
209019285 IL Physician Assistants & Advanced Practice Nursing Providers
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
71008296A IN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 101 INDUSTRY RD
City BRIDGEPORT
State IL
Zip Code 62417-2442

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124673256 Gretchen Ginder Family Medicine 101 Industry Rd, Bridgeport, IL 62417-2442 2019-08-06

Providers in the same zip code

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1346243672 Ernest & Susan L Roales Pharmacy 208 N Main St, Bridgeport, IL 62417-1522 2005-05-31
1053810390 Ernest Paul Roales Pharmacist 208 N Main St, Bridgeport, IL 62417-1522 2018-02-01
1871677005 Albert W Lewis Ambulance 1305 Ash St, Bridgeport, IL 62417-1707 2006-10-24
1144643354 Aperion Care Bridgeport LLC Durable Medical Equipment & Medical Supplies 900 Corporation St, Bridgeport, IL 62417-2206 2014-01-23
1184613515 Lawrence Community Healthcare Center Inc Skilled Nursing Facility 900 Corporation Line St, Bridgeport, IL 62417-2206 2005-10-18
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1366694317 Lawrence Community Healthcare Center Durable Medical Equipment & Medical Supplies 900 Corporation Line St, Bridgeport, IL 62417-2206 2008-10-21
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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1801293824 Tanya R Bassett Nurse Practitioner 46 Albion St, Southwest Community Health Center, Bridgeport, CT 06605-2602 2014-11-20
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Competitor

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City BRIDGEPORT
Zip Code 62417

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Dataset Information

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.

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