LORI ANGELEENE MODLY (NPI# 1871860692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871860692 |
Entity Type | Individual |
Full Name | LORI ANGELEENE MODLY |
Other Name | LORI ANGELEENE O'SHEA |
Credential | CPNP |
Practice Address |
743 Spring St Ne Gainesville GA 30501-3715 |
Mailing Address |
Po Box 658 Gainesville GA 30503-0658 |
Practice Telephone | 7705353611 |
Practice Fax Number | 7705357092 |
Mailing Telephone | 7707181122 |
Mailing Fax Number | 7705357445 |
Enumeration Date | 2011-11-22 |
Last Update Date | 2012-02-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN201247 | GA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003116595A | 05 | |
GA | WELLCARE | 643406 | 01 |
GA | AMERIGROUP | 01467542 | 01 |
Street Address |
743 SPRING ST NE |
City | GAINESVILLE |
State | GA |
Zip Code | 30501-3715 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841293958 | J. Taylor Henson | Internal Medicine | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2005-05-23 |
1598362303 | Rebecca Neff | Anesthesiologist Assistant | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-10-05 |
1942817648 | Frank James Vizen | Registered Nurse | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-09-26 |
1285240580 | Jennifer Erin Wood | Nurse Practitioner | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-09-22 |
1174139026 | Corey Barron | Nurse Practitioner | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-09-16 |
1235743451 | Christy Tepic | Anesthesiologist Assistant | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-09-04 |
1073126439 | Ashley Banks | Nurse Practitioner | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-08-26 |
1144838665 | Albert Duane Hancock | Nurse Practitioner | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-07-21 |
1255957718 | Krystle Dunn | Pathology | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-06-21 |
1922624428 | Abdullah Asreb | Student in an Organized Health Care Education/Training Program | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2020-06-19 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
Find all providers in zip 30501 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588271233 | Olivia Janelle De Jong | Nurse Practitioner | 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 | 2020-09-28 |
1275771032 | Wahida M. Siddiqi | Nurse Practitioner | 816 Sw 64th Ter, Gainesville, FL 32607-3556 | 2009-01-30 |
1588818843 | Alma Marie Nakasone | Nurse Practitioner | 3030 Mcever Rd, Building 1 Suite 130, Gainesville, GA 30504-5579 | 2008-11-12 |
1023141959 | Stacia Marie Hays | Nurse Practitioner | University of Florida College of Nursing, Box 100197, Gainesville, FL 32610-0197 | 2007-03-13 |
1790810760 | Michelle Bowers | Nurse Practitioner | 2005 Sw 75th St, Gainesville, FL 32607-3425 | 2007-02-22 |
1194708065 | Pamela Pieper | Nurse Practitioner | 101 S Newell Drive, Gainesville, FL 32611 | 2005-11-23 |
1104427251 | Morgan Elizabeth Gilbert | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-11-05 |
1922628445 | Kathryn Mary Mcfadden | Nurse Practitioner | 1699 Sw 16th Ave Bldg A, Gainesville, FL 32608-1158 | 2020-04-24 |
1699307314 | Lauren Gooch | Nurse Practitioner | 1485 Jesse Jewell Pkwy Ne Ste 200, Gainesville, GA 30501-3802 | 2020-02-11 |
1902451610 | Kristina Panagiotopoulos | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2019-08-08 |
Find all providers in GAINESVILLE |
City | GAINESVILLE |
Zip Code | 30501 |
Please comment or provide details below to improve the information on LORI ANGELEENE MODLY.
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.