Evernorth Care Providers - Delaware Pa | |
320 Decker Dr Irving TX 75062-3999 | |
(773) 292-4800 | |
(312) 564-4059 |
Full Name | Evernorth Care Providers - Delaware Pa |
---|---|
Speciality | General Practice |
Location | 320 Decker Dr, Irving, Texas |
Authorized Official Name and Position | Grace Blue (CREDENTIALING SR. MANAGER) |
Authorized Official Contact | 7732924800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Evernorth Care Providers - Delaware Pa 730 Cool Springs Blvd Ste 500 Franklin TN 37067-7331 Ph: (773) 292-4800 | Evernorth Care Providers - Delaware Pa 320 Decker Dr Irving TX 75062-3999 Ph: (773) 292-4800 |
NPI Number | 1033981097 |
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Provider Enumeration Date | 10/24/2023 |
Last Update Date | 11/17/2023 |
Medicare PECOS PAC ID | 6002217973 |
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Medicare Enrollment ID | O20240206004349 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033981097 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Jolene Sonnier Hanzik |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720139314 PECOS PAC ID: 4183639149 Enrollment ID: I20060213000134 |
Provider Name | Sharon Harrison |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316014822 PECOS PAC ID: 4385714146 Enrollment ID: I20080605000134 |
Provider Name | Melanie M Schneidmiller |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083852347 PECOS PAC ID: 9335287762 Enrollment ID: I20091105000181 |
Provider Name | Nancy G Boone |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750517512 PECOS PAC ID: 9638294895 Enrollment ID: I20100913000507 |
Provider Name | Lindsay A Valle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134409261 PECOS PAC ID: 3577737865 Enrollment ID: I20111123000170 |
Provider Name | Charity Mugadza |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568715514 PECOS PAC ID: 6800040957 Enrollment ID: I20130125000451 |
Provider Name | Charlotte Isah |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366883035 PECOS PAC ID: 2466686860 Enrollment ID: I20131017000753 |
Provider Name | Rose Murff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407144306 PECOS PAC ID: 5294958658 Enrollment ID: I20140603002435 |
Provider Name | Miranda N Sims |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588058259 PECOS PAC ID: 5698093722 Enrollment ID: I20150421001276 |
Provider Name | Thelma I Arzu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750788782 PECOS PAC ID: 9133440365 Enrollment ID: I20150601000171 |
Provider Name | Elisabeth Buchanan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356618748 PECOS PAC ID: 4789828526 Enrollment ID: I20150729009442 |
Provider Name | Bridie Mwaiki Yalala |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104213800 PECOS PAC ID: 0345340170 Enrollment ID: I20150908001036 |
Provider Name | Karen Sue Farnum |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487039087 PECOS PAC ID: 4385950252 Enrollment ID: I20150909000491 |
Provider Name | Chrystal L Pena |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699155689 PECOS PAC ID: 2860709748 Enrollment ID: I20150910001220 |
Provider Name | Washington O Mitema |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154709798 PECOS PAC ID: 4385952530 Enrollment ID: I20151007002723 |
Provider Name | Jernae F Bijou |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518362896 PECOS PAC ID: 8729397682 Enrollment ID: I20151016001125 |
Provider Name | Germaine N Tezano |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396114708 PECOS PAC ID: 4789985763 Enrollment ID: I20151216001325 |
Provider Name | Tammy Danise Smith |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1841675253 PECOS PAC ID: 8527369040 Enrollment ID: I20151228002268 |
Provider Name | Waylon C Bergeron |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306209721 PECOS PAC ID: 5799084000 Enrollment ID: I20160506001976 |
Provider Name | Mercy Olumuyiwa |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598129504 PECOS PAC ID: 4082903620 Enrollment ID: I20160520000355 |
Provider Name | Rafael Gonzalez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902265788 PECOS PAC ID: 0345530747 Enrollment ID: I20160525003050 |
Provider Name | Julia Holcombe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174908974 PECOS PAC ID: 2567755101 Enrollment ID: I20160720000941 |
Provider Name | Susan Jacob |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821468257 PECOS PAC ID: 3375853054 Enrollment ID: I20160921000937 |
Provider Name | Kelli N Rollins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538608971 PECOS PAC ID: 6305120312 Enrollment ID: I20170310000577 |
Provider Name | Peter Chan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649637489 PECOS PAC ID: 7618252958 Enrollment ID: I20170328002245 |
Provider Name | Abiola Atobatele |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164971453 PECOS PAC ID: 0749550606 Enrollment ID: I20170725004036 |
Provider Name | Margaret N Ndichu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831633973 PECOS PAC ID: 6709143449 Enrollment ID: I20171205000974 |
Provider Name | Norma Linda Cantu-castaneda |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043743750 PECOS PAC ID: 5991065963 Enrollment ID: I20180213000316 |
Provider Name | Erica Y Meeks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316458805 PECOS PAC ID: 7517222698 Enrollment ID: I20180518001190 |
Provider Name | Lauren B Cordell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518353812 PECOS PAC ID: 9931420643 Enrollment ID: I20180521000915 |
Provider Name | Candace Breaux |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366676132 PECOS PAC ID: 2264784586 Enrollment ID: I20181015000300 |
Provider Name | Rene R Gonzalez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538630355 PECOS PAC ID: 8921343435 Enrollment ID: I20190102001429 |
Provider Name | Courtney E Clifton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396212437 PECOS PAC ID: 7911243431 Enrollment ID: I20190103002834 |
Provider Name | Rhonda K Munoz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376017301 PECOS PAC ID: 6901147438 Enrollment ID: I20190411000282 |
Provider Name | Kenyatta Robinson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417452889 PECOS PAC ID: 4587098132 Enrollment ID: I20200107002009 |
Provider Name | Daniella Simona Ytuarte |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194360685 PECOS PAC ID: 1456789296 Enrollment ID: I20200310001548 |
Provider Name | Pamela Gamble |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902454986 PECOS PAC ID: 1456782424 Enrollment ID: I20200506001941 |
Provider Name | Nancy E Tabot |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902443062 PECOS PAC ID: 7810311065 Enrollment ID: I20200721001418 |
Provider Name | Christina Campbell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881166940 PECOS PAC ID: 7113343872 Enrollment ID: I20200812003135 |
Provider Name | Amber D Warner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588275853 PECOS PAC ID: 4880847367 Enrollment ID: I20200825003005 |
Provider Name | Thresa D Lawson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851593107 PECOS PAC ID: 7810308145 Enrollment ID: I20201118000137 |
Provider Name | Tammy Womack |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144850637 PECOS PAC ID: 8628489788 Enrollment ID: I20201120000072 |
Provider Name | Anastansia Monayo Ratemo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922658442 PECOS PAC ID: 2466852611 Enrollment ID: I20210610000737 |
Provider Name | Breana Jackson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912504176 PECOS PAC ID: 3173923232 Enrollment ID: I20210610001313 |
Provider Name | Alejandra Flores |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891395133 PECOS PAC ID: 9638579147 Enrollment ID: I20210621000302 |
Provider Name | Olateju Ishola |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063086122 PECOS PAC ID: 7416358981 Enrollment ID: I20210622003044 |
Provider Name | Jeannette K George |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043987753 PECOS PAC ID: 2668878125 Enrollment ID: I20210908002721 |
Provider Name | Teresa Alonzo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194487934 PECOS PAC ID: 4981099124 Enrollment ID: I20220324002034 |
Provider Name | Shanedra Davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477825099 PECOS PAC ID: 5597150623 Enrollment ID: I20220328000699 |
Provider Name | Muhammad Aftkhar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386392249 PECOS PAC ID: 7911392055 Enrollment ID: I20220328000873 |
Provider Name | Rosemary Mbam |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477858397 PECOS PAC ID: 1052707577 Enrollment ID: I20220411001275 |
Provider Name | Blessing Okon Okpo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205500402 PECOS PAC ID: 3971980673 Enrollment ID: I20220518003090 |
Provider Name | Ramiro Delbosque |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144851882 PECOS PAC ID: 4880077981 Enrollment ID: I20220823002406 |
Provider Name | Ashleigh Scruggs Chavez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841676749 PECOS PAC ID: 2062898398 Enrollment ID: I20221010002504 |
Provider Name | Temitope Ojo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992205876 PECOS PAC ID: 5395118574 Enrollment ID: I20230309000838 |
Provider Name | Robin M Tobin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790388015 PECOS PAC ID: 2961876438 Enrollment ID: I20230323002325 |
Provider Name | Ashley Marie De La Fuente |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053021105 PECOS PAC ID: 3476928680 Enrollment ID: I20230331000283 |
Provider Name | Krystal Aileen Perez Franco |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770299034 PECOS PAC ID: 5799150876 Enrollment ID: I20230403000544 |
Provider Name | Bairat Shasi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770021230 PECOS PAC ID: 6002149796 Enrollment ID: I20230404001950 |
Provider Name | Malaya Deemer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629531900 PECOS PAC ID: 5991030728 Enrollment ID: I20230502001325 |
Provider Name | Janis Correa |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659906683 PECOS PAC ID: 3971960436 Enrollment ID: I20230530000579 |
Provider Name | Dora Tirado |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740846211 PECOS PAC ID: 3870929599 Enrollment ID: I20230605003342 |
Provider Name | Joy Onyeugwor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457058554 PECOS PAC ID: 7618334715 Enrollment ID: I20230606000139 |
Provider Name | Felicia Marie Ward |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366156754 PECOS PAC ID: 3577920545 Enrollment ID: I20230606003449 |
Provider Name | Pamela Renee White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962174565 PECOS PAC ID: 6800255472 Enrollment ID: I20230630000307 |
Provider Name | Nancy W Kiarie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356038079 PECOS PAC ID: 1153780515 Enrollment ID: I20230702000037 |
Provider Name | Veronica Gaytan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609564202 PECOS PAC ID: 4688036890 Enrollment ID: I20230818001684 |
Provider Name | Santa Badeg Sisay |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033857073 PECOS PAC ID: 2668826223 Enrollment ID: I20230929003060 |
Provider Name | Janja Matic |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336648757 PECOS PAC ID: 4082061262 Enrollment ID: I20231109000850 |
Provider Name | Jorge Pena |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407563844 PECOS PAC ID: 6709257447 Enrollment ID: I20231125000207 |
Provider Name | Charlie Kroelinger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538697784 PECOS PAC ID: 6204105810 Enrollment ID: I20240405001065 |
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