NICOLE NYBERG (NPI# 1841615770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841615770 |
| Entity Type | Individual |
| Full Name | NICOLE NYBERG |
| Credential | N.P. |
| Practice Address |
611 W. Park St Urbana IL 61801-2500 |
| Mailing Address |
611 W, Park St Bwpc Urbana IL 61801-2500 |
| Practice Telephone | 2173833311 |
| Mailing Telephone | 2173836941 |
| Mailing Fax Number | 2173834752 |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2014-03-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
209.011198 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
209.011198 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
611 W. PARK ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366454316 | Franklyn C Christensen | Obstetrics & Gynecology | 611 W. Park St, Urbana, IL 61801-2500 | 2006-08-11 |
| 1124424932 | Rica Saligan | Nurse Practitioner | 611 W. Park St, Urbana, IL 61801-2500 | 2014-11-06 |
| 1215354816 | Tiffany Kloeppel | Nurse Anesthetist, Certified Registered | 611 W. Park St, Urbana, IL 61801-2500 | 2014-03-21 |
| 1497044044 | Lashonda Gray | Registered Nurse | 611 W. Park St, Urbana, IL 61801-2500 | 2011-04-05 |
| 1558691444 | Kelly C Lash | Nurse Practitioner | 611 W. Park St, Urbana, IL 61801-2500 | 2009-12-28 |
| 1710150719 | Kristine Lea Herrman | Audiologist | 611 W. Park St, Audiology, Urbana, IL 61801-2500 | 2008-04-10 |
| 1851486559 | Paul M Arnold | Neurological Surgery | 611 W. Park St, Neurosurgery, Urbana, IL 61801 | 2006-10-04 |
| 1871693002 | Frank J Stephens | Pediatrics | 611 W. Park St, Urbana, IL 61801-2500 | 2006-09-25 |
| 1104929405 | Robert (bruce) B Wellman | Pathology | 611 W. Park St, Urbana, IL 61801-2500 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 363LN0005X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104082890 | Catherine Elizabeth Theorell | Nurse Practitioner | 611 W Park St, Urbana, IL 61801-2500 | 2008-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699229229 | Christie Gilbart | Nurse Practitioner | 537 W Belmont Ave, #3, Chicago, IL 60657-4677 | 2016-08-11 |
| 1164723656 | Geralyn Sue Prullage | Nurse Practitioner | 2910 Gilbert Ln, Alton, IL 62002-5504 | 2010-11-15 |
| 1811124936 | Denise Kirsten | Nurse Practitioner | 1653 W. Congress, Pkwy Nicu, Chicago, IL 60612 | 2009-06-16 |
| 1356942239 | Sara Mancuso | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-11-05 |
| 1912516667 | Raymond Vincent Garay | Nurse Practitioner | 1620 W Harrison St, Chicago, IL 60612-3801 | 2020-07-29 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
| 1255965208 | Kelly A Peterson | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-02-28 |
| 1710510433 | Helen Medina | Nurse Practitioner | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2020-02-20 |
| 1164053484 | Amber Sara Johnson | Nurse Practitioner | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2020-01-27 |
| 1013564962 | Jodi Lynn Isley | Nurse Practitioner | 503 N Maple St, Effingham, IL 62401-2099 | 2019-08-23 |
| Find all providers with the same taxonomy | ||||
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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.