JEFFREY JUDGE KETZLE (NPI# 1972691004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972691004 |
Entity Type | Individual |
Full Name | JEFFREY JUDGE KETZLE |
Credential | A.C.N.P. |
Practice Address |
4708 Alliance Blvd Suite 475 Plano TX 75093-5340 |
Mailing Address |
4537 Eldorado Dr Plano TX 75093-5406 |
Practice Telephone | 9729648500 |
Mailing Telephone | 9728670129 |
Enumeration Date | 2006-10-11 |
Last Update Date | 2008-03-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
709638 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
4708 ALLIANCE BLVD SUITE 475 |
City | PLANO |
State | TX |
Zip Code | 75093-5340 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689677940 | Gerhard Emil Maale IIi | Specialist | 4708 Alliance Blvd, Ste 710, Plano, TX 75093-5340 | 2005-05-31 |
1194360644 | Mundela Tshilanda | Nurse Practitioner | 4708 Alliance Blvd, Ste 600, Plano, TX 75093-5368 | 2019-11-07 |
1891155784 | Anna Ferris Martinez | Nurse Practitioner | 4708 Alliance Blvd, Suite 550, Plano, TX 75093-5340 | 2016-03-04 |
1558739789 | Elaine Allison Hess | Psychologist | 4708 Alliance Blvd, Pav I, Ste 700, Plano, TX 75093-5340 | 2015-09-03 |
1447655857 | Christian L Moncrief Md Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4708 Alliance Blvd, Suite 770, Plano, TX 75093-5340 | 2014-10-28 |
1740605849 | Matthew Wiggins | Physician Assistant | 4708 Alliance Blvd, 810, Plano, TX 75093-5340 | 2014-02-26 |
1447514831 | Diana Margaret Kedora | Nurse Practitioner | 4708 Alliance Blvd, Pavilion I, Suite 300, Plano, TX 75093-5340 | 2012-06-29 |
1023372422 | Amy Nicole Merritt | Nurse Practitioner | 4708 Alliance Blvd, Pavilion I, Suite 600, Plano, TX 75093-5340 | 2012-06-29 |
1871860882 | Orthopedic Associates of Dallas LLP | Orthopaedic Surgery | 4708 Alliance Blvd, Suite 310, Plano, TX 75093-5340 | 2011-11-18 |
1780961045 | Texas Neurosurgical Institute Pa | Nurse Practitioner | 4708 Alliance Blvd, Suite 830 Pavilion I, Plano, TX 75093-5340 | 2011-11-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235789041 | Mapleshade Surgery Center, LLC | Clinic/Center | 960 Ohio Dr, Plano, TX 75093 | 2019-09-13 |
1003461468 | Psyclear, LLC | Psychologist | 5055 West Park Boulevard, Suite 400, Plano, TX 75093 | 2019-08-02 |
1962981795 | Ep Anesthesia Pllc | Anesthesiology | 4100 Mapleshade Ln, Plano, TX 75093 | 2018-08-13 |
1669973939 | Eva Walekhwa | Registered Nurse | 6000 Ohio Drive, Apt 1027, Plano, TX 75093 | 2018-02-22 |
1437657624 | Advanced Spine Center | Orthopaedic Surgery | 1705 Ohio Drive, Suite 300, Plano, TX 75093 | 2018-01-23 |
1184139974 | Erica Cherese Carey | Nurse Practitioner | 1100 Allied Drive, Plano, TX 75093 | 2017-12-04 |
1457865578 | Norma Vigilant | Specialist/Technologist, Other | 4909 West Park Blvd, Plaza Park Salons, Plano, TX 75093 | 2017-11-28 |
1891214011 | Americare Rx Pharmacy Inc | Pharmacy | 4010 W. 15th St., Ste 60, Plano, TX 75093 | 2017-09-19 |
1760912554 | Baylor Surgicare At Baylor Plano, LLC | Clinic/Center | 4825 Alliance, Sute 300, Plano, TX 75093 | 2017-06-14 |
1881133262 | Dr.seshagiri Rao | Preferred Provider Organization | 3016 Communications Pkwy, Ste 100, Plano, TX 75093 | 2017-02-17 |
Find all providers in zip 75093 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184139974 | Erica Cherese Carey | Nurse Practitioner | 1100 Allied Drive, Plano, TX 75093 | 2017-12-04 |
1104291483 | Lindsey Baxter | Nurse Practitioner | 2401 Trailwest Lane, Plano, TX 75025 | 2015-12-11 |
1194345850 | Adrienne Camille Greeney | Nurse Practitioner | 1100 Allied Dr, Plano, TX 75093-5348 | 2020-04-23 |
1679110332 | Charles James Mckenna | Nurse Practitioner | 6124 W Parker Rd Ste 530, Plano, TX 75093-8140 | 2019-12-02 |
1376187682 | Tabtiha Jean Inge | Nurse Practitioner | 3901 W 15th St, Plano, TX 75075-7738 | 2019-10-30 |
1447715503 | Shabnam Gettu Gill | Nurse Practitioner | 6130 W Parker Rd Ste 516, Plano, TX 75093-8033 | 2019-02-04 |
1538636444 | Jessica Lee Whitis | Nurse Practitioner | 1600 Coit Rd Ste 104, Plano, TX 75075-6171 | 2018-10-29 |
1790251585 | Laura Hayes | Nurse Practitioner | 1100 Allied Dr, Plano, TX 75093-5348 | 2018-10-18 |
1760957088 | Baneen Fatima Manekia | Nurse Practitioner | 6300 W Parker Rd Ste 322, Plano, TX 75093-8103 | 2018-10-13 |
1831672088 | Preethy Sara Oommen | Nurse Practitioner | 6124 W Parker Rd Ste 536, Plano, TX 75093-8137 | 2018-09-13 |
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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.