SANDRA AVITIA (NPI# 1871969105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871969105 |
| Entity Type | Individual |
| Full Name | SANDRA AVITIA |
| Credential | NP-C |
| Practice Address |
3200 Chouteau Ave Saint Louis MO 63103-2910 |
| Mailing Address |
31 Peartree Ln Glen Carbon IL 62034-4312 |
| Practice Telephone | 3149771250 |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2018-01-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209013047 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2015026485 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
209013047 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033394911 | Sandra Avitia | Dietitian, Registered | 2111 Wesley Ave, Berwyn, IL 60402-1860 | 2008-01-09 |
| Street Address |
3200 CHOUTEAU AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63103-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932611522 | Nicole Marie Humphrey | Nurse Practitioner | 3200 Chouteau Ave, Saint Louis, MO 63103-2910 | 2017-11-03 |
| 1588181051 | Stephen Walter Pitchford | Registered Nurse | 3200 Chouteau Ave, Saint Louis, MO 63103-2910 | 2017-08-25 |
| 1669614814 | Matthew Davis Kennedy | Physical Therapist | 3200 Chouteau Ave, Saint Louis, MO 63103-2910 | 2009-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306355045 | Dimensions of Care | Home Health | 1911washington Ave, Saint Louis, MO 63103 | 2017-09-26 |
| 1467972752 | Rebecca Jones | Social Worker | 1430 Olive Street, 500, St. Louis, MO 63103 | 2017-06-27 |
| 1780124511 | Priority Consumer Directed Services LLC | Home Health | 1409 Washintong Ave, Suite 504, Saint Louis, MO 63103 | 2017-02-27 |
| 1437562766 | Lindsey's Stepping Stones LLC | In Home Supportive Care | 1409 Washibgton Ave Suite 208, Saint Louis, MO 63103 | 2014-06-04 |
| 1952711046 | Jonathan Burch | Specialist/Technologist | 3330 Laclede Avenue, Saint Louis University - Chaifetz Arena, Saint Louis, MO 63103 | 2014-04-29 |
| 1912329954 | Chanel Mitchell | Social Worker | 1430 Olive, Suite 500, Saint Louis, MO 63103 | 2014-01-10 |
| 1194067116 | Hassan R Jafri | Physical Therapist | 1722 Olive, Sutie 201, St. Louis, MO 63103 | 2013-03-18 |
| 1710240023 | Dorothy Harris | Licensed Practical Nurse | 615 North Grand, Saint Louis, MO 63103 | 2012-06-21 |
| 1932407335 | Terence Michael Crowley | Chiropractor | 3141 Locust St Ste 200, Saint Louis, MO 63103 | 2011-03-09 |
| 1104123470 | Thompson Home Health Team LLC | Chore Provider | 3101 Olive Street, St Louis, MO 63103 | 2011-02-22 |
| Find all providers in zip 63103 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992270011 | Andrew Joseph Gucciardo | Nurse Practitioner | 12348 Old Tesson Rd Ste 250, Saint Louis, MO 63128-2261 | 2018-10-04 |
| 1548763121 | Jennifer Williams | Nurse Practitioner | 4618 Colima Ct, Saint Louis, MO 63128-2309 | 2018-03-09 |
| 1154862225 | Kelly Ann Esposito | Nurse Practitioner | 1040 N Mason Rd Ste 115, Saint Louis, MO 63141-6361 | 2017-03-09 |
| 1891161873 | Kay-ann Lawrence-merchant | Nurse Practitioner | 5229 Nottingham Estates Dr, Saint Louis, MO 63129-1548 | 2015-08-13 |
| 1568062669 | Uche Olateru | Nurse Practitioner | 3535 S Jefferson Ave Ste 104, Saint Louis, MO 63118-3907 | 2020-10-28 |
| 1952928665 | Rebecca Goodwillie | Nurse Practitioner | 3015 N Ballas Rd, Saint Louis, MO 63131-2329 | 2020-06-29 |
| 1295364594 | Gina Lisette Gardner | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-04-07 |
| 1609411784 | Ashley Titchenal | Nurse Practitioner | 11155 Dunn Rd Ste 304e, Saint Louis, MO 63136-6111 | 2019-11-12 |
| 1972145787 | Emily Sarah Cherry | Nurse Practitioner | 4921 Parkview Pl, Ste 11c, Saint Louis, MO 63110-1032 | 2019-10-14 |
| 1952952905 | Dedra M Echols | Nurse Practitioner | 1 Jefferson Barracks Rd, Saint Louis, MO 63125-4181 | 2019-09-20 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63103 |
Please comment or provide details below to improve the information on SANDRA AVITIA.
| 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.