MITZI GERRETSEN (NPI# 1952765695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952765695 |
| Entity Type | Individual |
| Full Name | MITZI GERRETSEN |
| Credential | FNP-C |
| Practice Address |
301 S Newport Ave Conway MO 65632-8322 |
| Practice Telephone | 4175892050 |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2016009385 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
301 S NEWPORT AVE |
| City | CONWAY |
| State | MO |
| Zip Code | 65632-8322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759093 | Kendra Mcmillion | Nurse Practitioner | 301 S Newport Ave, Conway, MO 65632-8322 | 2020-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144416330 | Conway Family Clinic, Inc. | Clinic/Center | 301 S. Newport, Conway, MO 65632 | 2007-09-20 |
| 1679691117 | Humble Hearts Care Service | Day Training/Habilitation Specialist | 652 State Rd M, Conway, MO 65632 | 2007-03-26 |
| 1982680799 | Suzanne Thompson | Nurse Practitioner | 601 W. Jefferson St., Suite C, Conway, MO 65632 | 2005-12-22 |
| 1164408399 | Deanna M Twyman | Nurse Practitioner | 301 South Newport Avenue, Conway, MO 65632 | 2005-12-20 |
| 1013993898 | Conway Family Clinic, Inc. | Clinic/Center | 301 South Newport Avenue, Conway, MO 65632-0009 | 2005-12-22 |
| 1285063016 | Laclede County R-i School District | Local Education Agency (LEA) | 726 W Jefferson Ave, Conway, MO 65632-8206 | 2013-11-02 |
| 1194282376 | Lori Ann Hyde | Speech-Language Pathologist | 209 S Shiloh Ave, Conway, MO 65632-8238 | 2019-02-25 |
| 1659517613 | John R Strobel | Specialist/Technologist, Other | 520 Starvey Creek Rd, Conway, MO 65632-8606 | 2008-12-22 |
| 1902042971 | John Strobel | Specialist/Technologist, Other | 520 Starvey Creek Rd, Conway, MO 65632-8606 | 2008-12-22 |
| 1598328817 | Kelly Lynn Hileman | Massage Therapist | 511 W Ruby St, Conway, MO 65632-9623 | 2019-04-22 |
| Find all providers in zip 65632 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617594 | Mckenzie Lauren Cotton | Nurse Practitioner | 1065 Skyline Dr, Conway, AR 72032-3530 | 2020-10-25 |
| 1316566607 | Shannon Busby | Nurse Practitioner | 1505 Winterbrook Dr, Conway, AR 72034-3564 | 2020-04-16 |
| 1538798087 | Glenda Darlene Gore | Nurse Practitioner | 17 Kali Ct, Conway, AR 72032-9477 | 2020-04-06 |
| 1265071427 | Dana Aysha Niederhauser | Nurse Practitioner | 1250 Littlewood Cv, Conway, AR 72032-8986 | 2020-01-04 |
| 1285287680 | Joy Griffith | Nurse Practitioner | 2907 Percy Cir, Conway, AR 72034-5508 | 2019-07-24 |
| 1366094260 | Kerry Kathryn Lewis | Nurse Practitioner | 1910 Royal Dr, Conway, AR 72034-7346 | 2019-07-10 |
| 1487113148 | Laura B Kelly | Nurse Practitioner | 2300 Linda Dr, Conway, AR 72032-8999 | 2019-03-12 |
| 1780141069 | Ashleigh Lynn Kinon | Nurse Practitioner | 2065 Woodlawn Dr, Conway, SC 29526-7703 | 2019-02-22 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| Find all providers in CONWAY | ||||
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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.