MRS. JERI KELLETT CHARLES (NPI# 1851429229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851429229 |
| Entity Type | Individual |
| Full Name | MRS. JERI KELLETT CHARLES |
| Credential | FNP |
| Practice Address |
620 S Grove St Ste 105 Marshall TX 75670-5295 |
| Mailing Address |
Po Box 1326 Marshall TX 75671-1326 |
| Practice Telephone | 0393594419 |
| Practice Fax Number | 9039381246 |
| Mailing Telephone | 9039273782 |
| Mailing Fax Number | 9039271764 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP113202 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
68260-3151 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TX LICENSE | AP113202 | 01 |
| Street Address |
620 S GROVE ST STE 105 |
| City | MARSHALL |
| State | TX |
| Zip Code | 75670-5295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124163191 | David C Lopez | Social Worker | 620 S Grove St Ste 105, Marshall, TX 75670-5295 | 2007-02-20 |
| 1043793664 | Lindsey Montgomery | Social Worker | 620 S Grove St Ste 105, Marshall, TX 75670-5295 | 2018-09-10 |
| 1922532555 | East Texas Border Health Clinic | Clinic/Center | 620 S Grove St Ste 105, Marshall, TX 75670-5295 | 2017-04-20 |
| 1710325188 | Kyle Martin Howard | Pediatrics | 620 S Grove St Ste 105, Marshall, TX 75670 | 2013-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912536988 | Christopher Hurd | Counselor | 1006 E East End Blvd N, Marshall, TX 75670 | 2020-04-02 |
| 1912547274 | Katie Bennett | Pharmacist | 300 E End Blvd, Marshall, TX 75670 | 2020-01-14 |
| 1083263677 | Fresh Start East Texas Counseling Services | Clinic/Center | 202 S. Alamo Blvd. Suite A, Marshall, TX 75670 | 2019-09-06 |
| 1376045831 | Tonja Deem | Nurse Practitioner | 815 S Wahshington Ave Ste 302, Marshall, TX 75670 | 2018-03-01 |
| 1609399641 | Michael Alan Rich Jr. | Specialist/Technologist | One Tiger Drive, East Texas Baptist University, Marshall, TX 75670 | 2017-07-21 |
| 1902359987 | Marshall Smiles Pllc | Dentist | 900 E End Blvd N, 200, Marshall, TX 75670 | 2016-07-26 |
| 1669871158 | Marshall Dental PC | Dentist | 900 East End Blvd., Suite 200, Marshall, TX 75670 | 2014-08-20 |
| 1629486717 | Winnie-stowell Hospital District | Skilled Nursing Facility | 1007 South Washington Avenue, Marshall, TX 75670 | 2014-08-01 |
| 1558636407 | Valerie Butler | Internal Medicine | 815 South Washington Avenue, Ste 100 Internal Medicine Marshall, Marshall, TX 75670 | 2012-03-11 |
| 1730478686 | John Lloyd English | Nurse Practitioner | 618 S Grove St Ste 100-300, Marshall, TX 75670 | 2011-03-31 |
| Find all providers in zip 75670 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578190088 | Michelle Ann Orange | Nurse Practitioner | 230 Wagon Trl, Marshall, AR 72650-7002 | 2020-03-25 |
| 1306499108 | Kari Ann Scarbrough | Nurse Practitioner | 200 N Madison, Marshall, MI 49068 | 2019-07-20 |
| 1679135958 | Bernice Alice Theule | Nurse Practitioner | 111 S Hamilton St, Marshall, MI 49068-1537 | 2019-07-08 |
| 1891207379 | Amy Ellen Jean Howell | Nurse Practitioner | 1174 W Michigan Ave Ste B, Marshall, MI 49068-1625 | 2017-10-24 |
| 1881132587 | Dana Zinn | Nurse Practitioner | 1547 Commerce Dr, Marshall, MO 65340 | 2017-02-02 |
| 1225587934 | Jeremy Scott Utley | Nurse Practitioner | 808 Harper Dr., Marshall, TX 75672 | 2016-09-23 |
| 1235594342 | Shelly Wisz | Nurse Practitioner | 720 Old Us 27 North, Marshall, MI 49068 | 2015-12-17 |
| 1730478686 | John Lloyd English | Nurse Practitioner | 618 S Grove St Ste 100-300, Marshall, TX 75670 | 2011-03-31 |
| 1669786216 | Pamela Madden Frisby | Nurse Practitioner | 4401 Us Hwy 25/70, Marshall, NC 28753 | 2010-08-05 |
| 1427293067 | Diane Marie Weinreich | Nurse Practitioner | 4 N Jefferson Ave, Marshall, MO 65340-2148 | 2008-12-11 |
| Find all providers in MARSHALL | ||||
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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.