DIANA MARIE MIKULENCAK-PICHA (NPI# 1790283596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790283596 |
| Entity Type | Individual |
| Full Name | DIANA MARIE MIKULENCAK-PICHA |
| Credential | NP-C |
| Practice Address |
1110 N Sarah Dewitt Dr Gonzales TX 78629-3311 |
| Mailing Address |
1430 N Avenue B Shiner TX 77984-6220 |
| Practice Telephone | 8306728502 |
| Mailing Telephone | 3614011344 |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 830443 | TX | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | AP136271 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1110 N SARAH DEWITT DR |
| City | GONZALES |
| State | TX |
| Zip Code | 78629-3311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376547919 | Humberto Rivas | Pediatrics | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2005-06-10 |
| 1649744301 | Terry Matthew Clay | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2019-01-16 |
| 1700231396 | Michael Mikesh | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-05-02 |
| 1285088377 | Steven Poteet | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-04-15 |
| 1255799755 | Karen Fortune | Speech-Language Pathologist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-29 |
| 1538527031 | Sheryl Breitschopf | Occupational Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-29 |
| 1932566577 | Sandra Johnston | Social Worker | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-27 |
| 1922465533 | Brittany Hill | Physical Therapist | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2016-01-27 |
| 1164840955 | Rikki Desiree Baldwin | Obstetrics & Gynecology | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2014-03-31 |
| 1164770996 | Victoria Emergency Partners LLC | Emergency Medicine | 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | 2012-08-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032072 | Bruce Franklin Blackwell | Pharmacist | 1114 East Sarah Dewitt Drive, Gonzales, TX 78629 | 2020-10-30 |
| 1790327765 | Gonzales County Emergency Services District 1 | Ambulance | 305 Qualls Street, Gonzales, TX 78629 | 2019-10-11 |
| 1831663400 | Caitlin Walker | Clinic/Center | 1300 Captain Albert Martin Trail, Gonzales, TX 78629 | 2019-01-17 |
| 1497251698 | Vaz Urgent Care Clinic, Pa | Clinic/Center | 1003 N Sarah Dewitt Drive, Gonzales, TX 78629 | 2018-04-05 |
| 1104348762 | Jeremiah Berryhill | Specialist/Technologist | 1711 E Sarah Dewitt Dr., Gonzales, TX 78629 | 2017-07-14 |
| 1073912861 | Gonzales County Senior Citizens Association, Inc | Home Delivered Meals | 818 Seydler Street, Gonzales, TX 78629 | 2014-08-18 |
| 1932544517 | Familylink Treatment Services | Counselor | 13326 Highway North 183, Gonzales, TX 78629 | 2013-05-08 |
| 1598035651 | H-e-b, Lp | Clinical Medical Laboratory | 1841 Church St., Gonzales, TX 78629 | 2012-01-06 |
| 1942441159 | Rebecca P. Bohach | Licensed Vocational Nurse | 228 St. George, Community Health Centers of South Central Texas, Inc, Gonzales, TX 78629 | 2009-03-18 |
| 1376763631 | Gonzales Isd | Local Education Agency (LEA) | 535 Fair St., Gonzales, TX 78629 | 2007-04-27 |
| Find all providers in zip 78629 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275978678 | Holly Sue Anne Delatte | Nurse Practitioner | 13504 Chase St, Gonzales, LA 70737-6091 | 2013-04-30 |
| 1326365198 | Darla Lynn Kiffe | Nurse Practitioner | 1943-a S. Burnside Ave., Gonzales, LA 70737 | 2010-05-03 |
| 1568845493 | Kathryn Jewell | Nurse Practitioner | 1937 S Burnside Ave, Gonzales, LA 70737-4632 | 2015-07-09 |
| 1750729836 | Dayna G Toscano | Nurse Practitioner | 1125 W Highway 30, Gonzales, LA 70737-5004 | 2013-06-11 |
| 1164776548 | Katherine D Paterson | Nurse Practitioner | 228 Saint George St, Gonzales, TX 78629-3910 | 2012-11-06 |
| 1891018867 | Margaret D. Mahler | Nurse Practitioner | 1014 Saint Clair Blvd, Suite 3030, Gonzales, LA 70737-5023 | 2010-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992306245 | Julie Gunnarson | Nurse Practitioner | 435 Tioga St, Burleson, TX 76028-8197 | 2020-11-03 |
| 1033710488 | Angela Renee Aston | Nurse Practitioner | 805 Kelly Creek, Bulverde, TX 78163 | 2020-11-03 |
| 1629678347 | Prime Telecare LLC | Nurse Practitioner | 2251 Bagdad Rd Unit 102, Cedar Park, TX 78613-6521 | 2020-10-30 |
| 1063012508 | Kelsey Jean Reisch | Nurse Practitioner | 5001 Orleans Cir, Rowlett, TX 75088-6175 | 2020-10-26 |
| 1124628557 | Jessica Buchanan | Nurse Practitioner | 212 Sheridan Loop, Belton, TX 76513-8024 | 2020-10-26 |
| 1811596323 | Rachel Christine Jarrell | Nurse Practitioner | 10080 Research Forest Dr, The Woodlands, TX 77354-6780 | 2020-10-26 |
| 1356940837 | Katherine Anna Nack | Nurse Practitioner | 6100 Harris Pkwy Ste 285, Fort Worth, TX 76132-4127 | 2020-10-26 |
| 1558960104 | Suzette Roberts | Nurse Practitioner | 2505 Pebble Lodge Ln, Friendswood, TX 77546-5587 | 2020-10-23 |
| 1982203675 | Ilse Deyanire Trevino | Nurse Practitioner | 6233 Tepepan Dr, Brownsville, TX 78521-7135 | 2020-10-22 |
| 1629677612 | Laurel Sunde | Nurse Practitioner | 11111 Research Blvd-ll2, Austin, TX 78759 | 2020-10-20 |
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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.