CINXE.COM

LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE "","","","NEVADA FIRST CHOICE, LLC","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1023572658","","2729 E MAIN STREET, STE 102","MESA","AZ","85213","1128a1","20241120","00000000","00000000","" "","","","NEW LIFE WELLNESS CENTER, LLC","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1164013959","","3725 E ROESER RD, STE 15","PHOENIX","AZ","85040","1128a1","20241120","00000000","00000000","" "","","","NEW LIFE WELLNESS FLAGSTAFF, L","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1144983180","","3104 E CAMELBACK RD, PMB 242","PHOENIX","AZ","85016","1128a1","20241120","00000000","00000000","" "ABDI","ALI","DUBOW","","EMPLOYEE - PRIVATE S","TRANSPORTATION CO","","0000000000","19860101","1738 PATRICKS BAY","FARIBAULT","MN","55021","1128a1","20241120","00000000","00000000","" "ACOSTA-CABRERA","YENISLEY","","","IND- LIC HC SERV PRO","TECHNICIAN","","1154095974","19910620","21801 SW 111TH AVENUE","MIAMI","FL","33170","1128b5","20241120","00000000","00000000","" "ADAMS","BRIDGET","","","IND- LIC HC SERV PRO","COUNSELOR","","1013542000","19831201","16756 CHINO CORONA ROAD","CORONA","CA","92880","1128a2","20241120","00000000","00000000","" "ADEWALE","ADEYANJU","","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19830411","P O BOX 8000","BRADFORD","PA","16701","1128a1","20241120","00000000","00000000","" "AGRIAM","EVELYN","","","BUS OWNER/EXEC","ADULT HOME","","0000000000","19540318","68285 ENCINITAS ROAD","CATHEDRAL CITY","CA","92234","1128a2","20241120","00000000","00000000","" "AHERN","ROBERT","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19951213","59 LINCOLN WAY E, APT 908","MASSILLON","OH","44646","1128a2","20241120","00000000","00000000","" "AKIN","JASON","MAX","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19770606","P O BOX 3949","PENSACOLA","FL","32516","1128a1","20241120","00000000","00000000","" "AKULA","SHIVA","","","PHYSICIAN (MD, DO)","INFECTIOUS DISEASE","","1679643639","19560304","P O BOX 34550","MEMPHIS","TN","38184","1128a1","20241120","00000000","00000000","" "ANDERSON","DAWN","ELLEN","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19781006","4510 18 1/2 MILE ROAD","MARSHALL","MI","49068","1128b4","20241120","00000000","00000000","" "ANDREWS","JERRY","WAYNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1295395952","19710812","P O BOX 158","LOWELL","FL","32663","1128b4","20241120","00000000","00000000","" "ANDREWS","WANDA","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19480805","916 E SUBLETTE ST","POCATELLO","ID","83201","1128a1","20241120","00000000","00000000","" "APELLANIZ","RAMON","A","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","1740690692","19850204","335 BILTON ROAD, P O BOX 100","SOMERS","CT","06071","1128a1","20241120","00000000","00000000","" "ATWELL","JEANINE","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1275863003","19840907","310 CRESTWOOD LANE","LOUISVILLE","KY","40229","1128b4","20241120","00000000","00000000","" "BAGHERI","AMINOLLAH","T","","IND- LIC HC SERV PRO","DENTIST","","1659338523","19710921","1540 6TH AVENUE, APT 3","SAN FRANCISCO","CA","94122","1128a1","20241120","00000000","00000000","" "BAKER","BROCK","","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19791214","1536 E 455TH RD","BOLIVAR","MO","65613","1128a1","20241120","00000000","00000000","" "BALL","ASHLEY","ERWIN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1255630778","19880909","6304 CROOKED CREEK DRIVE","MASON","OH","45040","1128b4","20241120","00000000","00000000","" "BALLARD","LEE ANNA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640128","450 W DADE 12","LOCKWOOD","MO","65682","1128b4","20241120","00000000","00000000","" "BANISTER","STEPHEN","","","PHYSICIAN (MD, DO)","PAIN MANAGEMENT","","1376768416","19450722","11865 BLACK OAK DR","NEVADA CITY","CA","95959","1128b4","20241120","00000000","00000000","" "BARKLEY","NINA","MARIE","","IND- LIC HC SERV PRO","COUNSELOR","","1407238892","19870415","432 GRINDSTONE ROAD","GRINDSTONE","PA","15442","1128a3","20241120","00000000","00000000","" "BARNARD","TERRANCE","","","EMPLOYEE - PRIVATE S","LABORATORY","","0000000000","19830801","P O BOX 15330","FORTH WORTH","TX","76119","1128a3","20241120","00000000","00000000","" "BARNUM","TABITHA","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","1194327080","19850220","100 MARTHA DR","MADISON","OH","44057","1128a1","20241120","00000000","00000000","" "BARR","REX","A JR","","BUS OWNER/EXEC","TRANSPORTATION CO","","0000000000","19850926","1324 NORTH HOWARD STREET","PHILADELPHIA","PA","19122","1128a1","20241120","00000000","00000000","" "BATTS","SAMANTHA","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19870407","ROUTE 37","DANBURY","CT","06811","1128b4","20241120","00000000","00000000","" "BAUL","TERRY","S","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1942375837","19510521","5421 W OUTER DR","DETROIT","MI","48235","1128a1","20241120","00000000","00000000","" "BECK","SEAN","J","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19900401","3046 ATAZAR WAY","MELBOURNE","FL","32940","1128a1","20241120","00000000","00000000","" "BELL","CHASSIDY","","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","1457834152","19891026","6984 REGATTA DR","SHREVEPORT","LA","71107","1128a1","20241120","00000000","00000000","" "BENNINGTON","ASTACIA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19780527","1441 ELMORE CT S","COLUMBUS","OH","43224","1128a3","20241120","00000000","00000000","" "BERDINE","MISTY","NICOLE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19901002","2361 SANSING HOLLOW ROAD","HARRISON","AR","72601","1128a1","20241120","00000000","00000000","" "BERNAUER","ROBERT","DALE","","PHYSICIAN (MD, DO)","ORTHOPEDICS","","1235211095","19461114","2208 CASTLE BAY DRIVE","LEAGUE CITY","TX","77573","1128a3","20241120","00000000","00000000","" "BESSON","DANNA","GAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1962034330","19640421","2614 QUARRY HILL ROAD","SUGAR LAND","TX","77478","1128b4","20241120","00000000","00000000","" "BETHEA","ETHEL","R","","IND- LIC HC SERV PRO","COUNSELOR","","1033402045","19630811","201 WEST MAIN STREET","NIANTIC","CT","06357","1128a1","20241120","00000000","00000000","" "BIRD","RANDALL","SCOTT","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770911","19443 N TOYA ST","MARICOPA","AZ","85138","1128b4","20241120","00000000","00000000","" "BLAZKOVEC","PAUL","ANDREW","","IND- LIC HC SERV PRO","PHARMACIST","","1689018160","19670405","2618 S 50TH STREET","MILWAUKEE","WI","53219","1128b4","20241120","00000000","00000000","" "BOCKOVER-DAVIS","MITCHELL","WAYNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19710408","P O BOX 5000","PEKIN","IL","61555","1128b4","20241120","00000000","00000000","" "BOOKER","LATAVIA","M","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","20010623","5187 CASS AVENUE","EVANSVILLE","IN","47715","1128a2","20241120","00000000","00000000","" "BOWMAN","BRIAN","","","BUS OWNER/EXEC","LABORATORY","","0000000000","19810627","MAXWELL AIR FORCE BASE","MONTGOMERY","AL","36112","1128a1","20241120","00000000","00000000","" "BOYD","JAMELL","CURTIS","","EMPLOYEE - PRIVATE S","COMM MNTL HLTH CNTR","","0000000000","19820131","101 N FRONT STREET","MINERSVILLE","PA","17954","1128a1","20241120","00000000","00000000","" "BOYD","SHERRESE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801227","129 CODDINGTON AVENUE","XENIA","OH","45385","1128a1","20241120","00000000","00000000","" "BOYLE","RYAN","P","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19780406","42 OREGON ROAD","ARMONK","NY","10504","1128a1","20241120","00000000","00000000","" "BRANHAM","TOMMY","WILLIS","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19540105","P O BOX 2095","COEBURN","VA","24230","1128a1","20241120","00000000","00000000","" "BRANNLUND","ALYSON","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830208","8409 N WINAN AVE","KANSAS CITY","MO","64153","1128b4","20241120","00000000","00000000","" "BROWN","VICTORIA","DANIELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890718","1008 N ELLOITT ST","EVANSVILLE","IN","47711","1128a2","20241120","00000000","00000000","" "BRUCE","INA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19630825","12351 WINDWARD DR","GULFPORT","MS","39503","1128b4","20241120","00000000","00000000","" "BRUNT","JASON","EDWARD","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1619979713","19690108","750 LANGLEY BLVD","CLAWSON","MI","48017","1128a4","20241120","00000000","00000000","" "BURNS","TINKA","JACQILLA","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19950815","2747 HIGHWAY 28 E, APT 1003","PINEVILLE","LA","71360","1128a2","20241120","00000000","00000000","" "CAIN","RUTHIE","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1669095030","19610206","5503 HIGHWAY 90 SPC 10R","CROSBY","TX","77532","1128b4","20241120","00000000","00000000","" "CALDERON-BLAKE","DANIELLE","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19831209","3709 HARDING DRIVE","COLUMBUS","OH","43228","1128a1","20241120","00000000","00000000","" "CALDERONE","DAVID","R JR","","IND- LIC HC SERV PRO","PODIATRY","","1144290115","19660331","41 W LEMON STREET, APT 602","LANCASTER","PA","17603","1128a1","20241120","00000000","00000000","" "CALE","SCOTT","GOODSON","","IND- LIC HC SERV PRO","DENTIST","","1972519056","19540424","4 PUTNAM AVENUE, 1","CHELMSFORD","MA","01824","1128a1","20241120","00000000","00000000","" "CAMPBELL","MELESIA","S","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1144871088","19890202","586 BLOOMFIELD AVE","CLIFTON","NJ","07012","1128b4","20241120","00000000","00000000","" "CARABALLO FIGUEROA","GIRALDO","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1811283435","19651209","15550 SW 109TH AVENUE","MIAMI","FL","33157","1128b4","20241120","00000000","00000000","" "CASAREZ","SOFIA","COME RIHI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660312","2888 S KILLARNEY WAY","AURORA","CO","80013","1128b4","20241120","00000000","00000000","" "CASEM","BRIAN","DAVID","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19650710","22244 W MARK LANE","WITTMANN","AZ","85361","1128b4","20241120","00000000","00000000","" "CASTLE","MARTHA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19721124","7088 COUNTY ROAD 320, APT 320","ENTERPRISE","MS","39330","1128b4","20241120","00000000","00000000","" "CEDRO","REBECCA","N DEJOS","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","1346941507","19671202","30405 DE PORTOLA ROAD","TEMECULA","CA","92592","1128a1","20241120","00000000","00000000","" "CHANCHIKYAN","ARTUR","","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19670912","6454 BONNER AVENUE, APT 645","NORTH HOLLYWOOD","CA","91606","1128b1","20241120","00000000","00000000","" "CHAPMAN","CHASTITY","TANEKA","","BUS OWNER/EXEC","ADULT HOME","","0000000000","19770323","211 FARMERS ROW","MADISON","MS","39110","1128a2","20241120","00000000","00000000","" "CHAPMAN","CRISTIE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19751128","46 MILLPOND DRIVE","HATTIESBURG","MS","39401","1128a2","20241120","00000000","00000000","" "CHAPMAN","PAMELA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810510","211 11TH STREET","MOUNT OLIVE","MS","39119","1128a2","20241120","00000000","00000000","" "CHATIGNY","MICHELLE","ANNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19550401","P O BOX 290161","PHELAN","CA","92329","1128b4","20241120","00000000","00000000","" "CHIN","TIMOTHY","A","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19580724","3101 NE 59TH TER","KANSAS CITY","MO","64119","1128a1","20241120","00000000","00000000","" "CLECKLER","TRASA","LARAE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830429","14393 S CAMINO EL GALAN","SAHUARITA","AZ","85629","1128b4","20241120","00000000","00000000","" "COLLINS","ASHLEY","","","BUS OWNER/EXEC","CLINIC","","0000000000","19860701","3601 BLYTHE FERRY LANE","BIRCHWOOD","TN","37308","1128a3","20241120","00000000","00000000","" "CONROD","VALERIE","","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19880214","112 PENNY CIR, APT C5","SUNFLOWER","MS","38778","1128a3","20241120","00000000","00000000","" "COOK","ASHLEY","ELAINE","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19900524","2527 SHERIDAN AVE N","MINNEAPOLIS","MN","55411","1128a1","20241120","00000000","00000000","" "COOK","WYLINDA","DEE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19610827","561 COUNTY ROAD 3100","KEMPNER","TX","76539","1128a1","20241120","00000000","00000000","" "DALE","TONYA","FRANKLIN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730205","3094 HALL DRIVE","GADSDEN","AL","35907","1128b4","20241120","00000000","00000000","" "DAVIS","MELANIE","NICOLE","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1518102946","19781014","5287 BRYCE CT","STERLING HEIGHTS","MI","48310","1128a1","20241120","00000000","00000000","" "DAWKINS","SHANETT","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19710308","13071 S ELLIS AVENUE","CHICAGO","IL","60827","1128a1","20241120","00000000","00000000","" "DE SOUZA","SERGIO","GOMES","","IND- LIC HC SERV PRO","DENTIST","","1952778532","19760412","26818 N 65TH DRIVE","PHOENIX","AZ","85083","1128b4","20241120","00000000","00000000","" "DIAMOND","SARAH","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920730","GLEN RAY ROAD, BOX A","ALDERSON","WV","24910","1128a4","20241120","00000000","00000000","" "DICKSON","HOLLY","LAUREEN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19621021","1938 MONTGOMERY AVENUE, #49","VENTURA","CA","93004","1128b4","20241120","00000000","00000000","" "DILLINGER","JASON","LAWRENCE","","IND- LIC HC SERV PRO","PHYSICIAN ASSISTANT","","1386060549","19780516","110 GILPIN DRIVE","WEST CHESTER","PA","19382","1128a4","20241120","00000000","00000000","" "DIX","ARIELL","OLIVIA","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","1831504430","19870119","P O BOX 3200","GOODYEAR","AZ","85338","1128a1","20241120","00000000","00000000","" "DURHAM","SIDNEY","L","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19790720","454 N ROYAL TOWER DR","IRMO","SC","29063","1128a3","20241120","00000000","00000000","" "EAKES","MARK","W","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1043508922","19640621","1944 RUE CHATEAU","CHULA VISTA","CA","91913","1128b4","20241120","00000000","00000000","" "EDMONDS","CARA","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19881018","432 E CHESTNUT STREET","WASHINGTON","PA","15301","1128b4","20241120","00000000","00000000","" "ESUA","MALVIS","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1053675223","19870610","7005 BLUE BIRD CT","LANHAM","MD","20706","1128b4","20241120","00000000","00000000","" "FANNIN","MELISSA","LOU","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800208","622 E 100 S","HARTFORD CITY","IN","47348","1128a4","20241120","00000000","00000000","" "FANNON","ROBERT","L","","IND- LIC HC SERV PRO","PHARMACIST","","1871615807","19490202","309 E FORREST ST","LA FOLLETTE","TN","37766","1128a4","20241120","00000000","00000000","" "FARMER","ALTHEA","MARIE","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19641118","7901 LAUREL LAKES CT, APT 306","LAUREL","MD","20707","1128b1","20241120","00000000","00000000","" "FARMER","KAY","LE","","BUS OWNER/EXEC","COUNSELING CENTER","","0000000000","19750426","P O BOX 2149","BRYAN","TX","77805","1128a1","20241120","00000000","00000000","" "FIDDES","KAYLEIGH","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19910821","398 BERING LN","SUMMERVILLE","SC","29486","1128b1","20241120","00000000","00000000","" "FISHER","ADRIEONNA","","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19930601","100 GRILLEYTOWN RD 10","WATERBURY","CT","06704","1128a1","20241120","00000000","00000000","" "FLORES","THERESA","","","BUS OWNER/EXEC","DENTAL PRACTICE","","1013325075","19780301","760 FIG AVENUE","HOLTVILLE","CA","92250","1128b2","20241120","00000000","00000000","" "FODER","DANIEL","JOSEPH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19870214","520 NEWPORT ROAD","BRISTOL","PA","19007","1128b4","20241120","00000000","00000000","" "FORD","DARREN","TYRONE","","INDIVIDUAL (UNAFFILI","RECRUITER/CAPPER","","0000000000","19660617","765 LINCOLN AVENUE, APT 15H","BROOKLYN","NY","11203","1128a1","20241120","00000000","00000000","" "FORSYTHE","MARY","MCCLELLAND","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19630306","3079 BEDILLION ROAD","WASHINGTON","PA","15301","1128b4","20241120","00000000","00000000","" "FRIEDMAN","MICHAEL","LANGE","","PHYSICIAN (MD, DO)","GYN/OBS","","1336338458","19421101","29126 WARNICK RD","RANCHO PALOS VERDES","CA","90275","1128b4","20241120","00000000","00000000","" "FULP","ANTAVIA","L","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19860301","504 OLD TIMBER ROAD","WINSTON SALEM","NC","27101","1128a2","20241120","00000000","00000000","" "GAIDHANE","VIRENDRA","","","IND- LIC HC SERV PRO","PHYSICAL THERAPY","","1265503288","19701129","P O BOX 2000","BRUCETON MILLS","WV","26525","1128a4","20241120","00000000","00000000","" "GALIK","LAUREN","RACHEL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900411","422 CARNEGIE STREET","WEST MIFFLIN","PA","15122","1128b4","20241120","00000000","00000000","" "GARCIA","KORI","AMBER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19771129","1400 SUNVIEW DR","SAINT LOUIS","MO","63146","1128b4","20241120","00000000","00000000","" "GERMAN","VLADISLAV","","","EMPLOYEE - PRIVATE S","CONSULTING FIRM","","0000000000","19720203","625 SUMMIT LANE","FRANKLIN LAKES","NJ","07417","1128a1","20241120","00000000","00000000","" "GHANNAM","AMERA","SOLIMAN","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","0000000000","19860611","7446 W TUMBLEWOOD DRIVE","PEORIA","AZ","85382","1128a1","20241120","00000000","00000000","" "GILBERT","JENNIFER","KAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19831130","9151 W KINGS AVENUE","PEORIA","AZ","85382","1128b4","20241120","00000000","00000000","" "GISE","RENEE","LORRAINE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1356480438","19571022","2311 CARLSBAD AVE, APT 22A","SACRAMENTO","CA","95821","1128b4","20241120","00000000","00000000","" "GLOTSER","ALEX","LEV","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1629462502","19870425","344 MARINE FORCES DR","GRAND PRAIRIE","TX","75051","1128a1","20241120","00000000","00000000","" "GLOVER-WING","KRISTAL","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730215","P O BOX 3725","ADELANTO","CA","92301","1128a1","20241120","00000000","00000000","" "GLUKOWSKY","REBECCA","ROSE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19641114","705 SOUTH WASHINGTON AVENUE","IOLA","KS","66749","1128a2","20241120","00000000","00000000","" "GONZALES","CHRISTIAN","DIONE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19781206","6233 W BEHREND DRIVE, APT 1071","GLENDALE","AZ","85308","1128b4","20241120","00000000","00000000","" "GONZALES","NICOLE","SUMMER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1619172889","19790702","5939 S BROADWAY","LITTLETON","CO","80121","1128b4","20241120","00000000","00000000","" "GONZALEZ","SILVESTRE","ALFREDO","","IND- LIC HC SERV PRO","PARAMEDIC TECHNICIAN","","0000000000","19931206","14287 WEEPING WILLOW LANE","FONTANA","CA","92337","1128b4","20241120","00000000","00000000","" "GORBETT","LYDIA","REYNALDA","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1871238295","19690128","4014 S COUNTY ROAD 925 W","MEDORA","IN","47260","1128b4","20241120","00000000","00000000","" "GOSS","BONTIEA","BERNADETTE","","BUS OWNER/EXEC","NON-PROFIT ORGANIZAT","","0000000000","19551019","P O BOX 14525","LEXINGTON","KY","40512","1128a3","20241120","00000000","00000000","" "GOSS","TOMMY","RAY","","BUS OWNER/EXEC","NON-PROFIT ORGANIZAT","","0000000000","19551104","P O BOX 5000","FLORENCE","CO","81226","1128a3","20241120","00000000","00000000","" "GOULD","ANTHONY","JOSEPH","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19910712","P O BOX 3949","PENSACOLA","FL","32516","1128a1","20241120","00000000","00000000","" "GOULIN","GARY","DAVID","","PHYSICIAN (MD, DO)","PEDIATRICS","","1891722476","19610204","9595 WEST QUINCY AVE","LITTLETON","CO","80123","1128b4","20241120","00000000","00000000","" "GRAF","DAVID","MATTHEW","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820608","11519 W CLOVER WAY","AVONDALE","AZ","85392","1128b4","20241120","00000000","00000000","" "GREEN","MARK","ANTHONY","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19650226","1770 ASHBROOK DRIVE","CINCINNATI","OH","45238","1128a1","20241120","00000000","00000000","" "GREINER","ALSON","LEE","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1588694350","19390413","2411 AUBURN AVENUE","CINCINNATI","OH","45219","1128b4","20241120","00000000","00000000","" "GRENIER","KRYSTAL","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19920911","554 SAND HILL ROAD","MILTON","VT","05468","1128a2","20241120","00000000","00000000","" "GRENIER","NICHOLAS","ROGER","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19921109","515 WEAVER RIDGE DRIVE","MARYSVILLE","OH","43040","1128a2","20241120","00000000","00000000","" "GUILLETTE","ABBEY","L","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19880407","3552 GLEN ROAD, #IN","NEWPORT","VT","05855","1128a1","20241120","00000000","00000000","" "GUTKIN","STANISLAV","","","EMPLOYEE - PRIVATE S","MANAGEMENT SVCS CO","","0000000000","19841006","485 WINDEMERE AVENUE","MOUNT ARLINGTON","NJ","07856","1128a1","20241120","00000000","00000000","" "GUZMAN","CASSANDRA","ALICIA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860601","5150 W EUGIE AVE APT 1034","GLENDALE","AZ","85304","1128b4","20241120","00000000","00000000","" "GWAIKOLO","MELVIN","M","","EMPLOYEE - PRIVATE S","ADULT HOME","","0000000000","19990206","712 OAKWOOD DR","GLENOLDEN","PA","19036","1128a2","20241120","00000000","00000000","" "HAGEN","JOSEPH","","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1811989650","19540908","13645 OSBORN AVE, APT 121","DEARBORN","MI","48126","1128a1","20241120","00000000","00000000","" "HAMRICK","CHRISTY","MICHELE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19720706","LOWELL ANNEX","OCALA","FL","34482","1128a4","20241120","00000000","00000000","" "HANNESYAN","PETROS","","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19850501","3901 KLEIN BLVD","LOMPOC","CA","93436","1128b1","20241120","00000000","00000000","" "HARRIS","AMANDA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19750423","502 MCWHIRTER ST","AMORY","MS","38821","1128b4","20241120","00000000","00000000","" "HARRIS","BRENDA","L","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19620624","4 ISLE LANE, UNIT 402","GRAND ISLE","VT","05458","1128a1","20241120","00000000","00000000","" "HARRIS","MYA","","","EMPLOYEE - ST/LOC/TR","STATE GOV'T","","0000000000","19910603","2652 SOUTH KARLOV AVENUE, APT","CHICAGO","IL","60623","1128a1","20241120","00000000","00000000","" "HAWKINS","TIACA","MONISELENAY","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19970402","414 OLD WESSON RD NE, LOT 12","BROOKHAVEN","MS","39601","1128a3","20241120","00000000","00000000","" "HAYES","MICHELLE","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19750523","30068 405TH STREET","MORAVIA","IA","52571","1128a1","20241120","00000000","00000000","" "HAYMER","RHONDA","MARIE","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19660719","8008 W 28TH ST, APT 205","MINNEAPOLIS","MN","55426","1128a1","20241120","00000000","00000000","" "HAYWOOD-GUTHRIE","SHAMIKA","","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19781022","1752 WOODSTREAM DRIVE","SAINT LOUIS","MO","63138","1128a1","20241120","00000000","00000000","" "HEARD","SHINALL","ANTWAN","","BUS OWNER/EXEC","TRANSPORTATION CO","","0000000000","19800324","2446 BURR OAK AVENUE, APT 2E","BLUE ISLAND","IL","60406","1128b5","20241120","00000000","00000000","" "HEARD","SOLOMON","A","","BUS OWNER/EXEC","TRANSPORTATION CO","","0000000000","19521111","2026 W 80TH PLACE","CHICAGO","IL","60620","1128b5","20241120","00000000","00000000","" "HEIDARY","PEYMAN","","","IND- LIC HC SERV PRO","CHIROPRACTIC","","1407985450","19700830","P O BOX 4000","VACAVILLE","CA","95696","1128a3","20241120","00000000","00000000","" "HERNDON","CHRISTOPHER","NORRIS","","PHYSICIAN (MD, DO)","GYN/OBS","","1265563019","19790224","6815 48TH AVE NE","SEATTLE","WA","98115","1128b4","20241120","00000000","00000000","" "HESS","AARON","LEE","","IND- LIC HC SERV PRO","PHYSICIAN ASSISTANT","","1073102679","19820808","4804 E EMORY ROAD","KNOXVILLE","TN","37938","1128b4","20241120","00000000","00000000","" "HICKERSON","APRIL","L","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1730273087","19580502","35 YOSEMITE DR","BEAR","DE","19701","1128a1","20241120","00000000","00000000","" "HILKER","CHRISTOPHER","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810807","6064 E HASSAYAMPA CIRCLE","SCOTTSDALE","AZ","85266","1128b4","20241120","00000000","00000000","" "HILLSMAN","JULIA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640117","17180 W SWEETWATER AVENUE, UNI","SURPRISE","AZ","85388","1128b4","20241120","00000000","00000000","" "HINTON","KERSEY","ROBERTSON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801212","P O BOX 98","NEWBERN","AL","36765","1128b4","20241120","00000000","00000000","" "HOBBS","SARAH","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19760224","1943 FELSPAR ST","SAN DIEGO","CA","92109","1128b4","20241120","00000000","00000000","" "HOFFER","KIMBERLY","G","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19720622","735 N CENTURY AVE","REPUBLIC","MO","65738","1128a4","20241120","00000000","00000000","" "HOFFMAN","PAUL","GEORGE","","PHYSICIAN (MD, DO)","SURGERY","","1770562977","19520326","3252 CARRIAGE DRIVE","MEDFORD","OR","97501","1128b4","20241120","00000000","00000000","" "HOPPER","JOHN","ALBERT","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19700915","568 EBENEZER ROAD","MURPHY","NC","28906","1128b4","20241120","00000000","00000000","" "HOUSER","HANNAH","SHAE BROCK","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890202","5221 NARROWS ROAD","LONSDALE","AR","72087","1128b4","20241120","00000000","00000000","" "HUNTER","QUINETTA","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19820710","P O BOX 3","PUEBLO","CO","81002","1128a1","20241120","00000000","00000000","" "HWANG","KYUMIN","","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19720829","5467 DORAL DR","WILMINGTON","DE","19808","1128a2","20241120","00000000","00000000","" "IHNEN","SIDNEY","KAYE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940227","3424 W ST","LINCOLN","NE","68503","1128b4","20241120","00000000","00000000","" "IZQUIERDO-MALON","ROMEL","","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1033422357","19681029","P O BOX 1000","MARION","IL","62959","1128a1","20241120","00000000","00000000","" "IZUOGU","KENNETH","IFEANYI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880215","22 BRAGAW AVE, APT 1","NEWARK","NJ","07112","1128b4","20241120","00000000","00000000","" "JACOBY","CONNIE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19511121","1513 JAKE LN","COLUMBIA","MO","65203","1128b4","20241120","00000000","00000000","" "JASPER","LEE","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19501002","604 BRIDGE STREET","SWEET SPRINGS","MO","65351","1128b4","20241120","00000000","00000000","" "JAVIER","ERIC","CORALDE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19651018","544 W SIERRA VISTA DRIVE","APACHE JUNCTION","AZ","85120","1128b4","20241120","00000000","00000000","" "JAYNES","SHARON","SHENILE","","EMPLOYEE - PRIVATE S","ADULT DAY CARE FACIL","","0000000000","19710104","10471 THREE RIVERS ROAD, APT 5","GULFPORT","MS","39503","1128a2","20241120","00000000","00000000","" "JOHNSON","TIARA","","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","1104420181","19941218","13731 MARTIN DRIVE","CLEVELAND","OH","44125","1128a1","20241120","00000000","00000000","" "JONES","CHRISTINA","SHADE","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19560702","125 SHELDON ROAD, APT 424","BEREA","OH","44017","1128b4","20241120","00000000","00000000","" "JOSEPH","PATRICIA","F","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920702","7968 STONEHINGE CT S","INDIANAPOLIS","IN","46260","1128b4","20241120","00000000","00000000","" "KABAKOV","ALEX","J SR","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19650523","2164 N WESTMORELAND DRIVE","PALATINE","IL","60074","1128b5","20241120","00000000","00000000","" "KAHN","LISA","D","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","1972931632","19600421","1530 W 29TH STREET","LORAIN","OH","44052","1128a1","20241120","00000000","00000000","" "KANE","MICHELLE","","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19680803","2827 140TH PL","BLUE ISLAND","IL","60406","1128a1","20241120","00000000","00000000","" "KARBAN","AMANDA","KRISTIN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1346803095","19810804","1026 CLOVER HILL CT","SULLIVAN","MO","63080","1128b4","20241120","00000000","00000000","" "KARIMI","PARTO","","","PHYSICIAN (MD, DO)","SURGERY","","1225225048","19640415","1155 N PINAL PARKWAY","FLORENCE","AZ","85132","1128a4","20241120","00000000","00000000","" "KEATON","KALEB","AASE","","IND- LIC HC SERV PRO","COUNSELOR","","1982953642","19850220","195 PANORAMA RIDGE RD","SANDPOINT","ID","83864","1128b4","20241120","00000000","00000000","" "KELLEY","KENNETH","ROBERT","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880402","9550 NORDMAN WAY","ELK GROVE","CA","95624","1128b4","20241120","00000000","00000000","" "KENT","ALEXANDRA","BAVIER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790108","3540 E RIOPELLE AVE","GILBERT","AZ","85298","1128b4","20241120","00000000","00000000","" "KHOURY","ANNE","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810122","1383A RENAISSANCE CIR","CHARLESTON","WV","25311","1128b4","20241120","00000000","00000000","" "KIM","GEOFFREY","S","","PHYSICIAN (MD, DO)","PLASTIC SURGERY","","1295952729","19690426","5420 S QUEBEC STREET, STE 204","ENGLEWOOD","CO","80111","1128a2","20241120","00000000","00000000","" "KONDUS","JOHN","STEPHEN","","IND- LIC HC SERV PRO","CHIROPRACTIC","","1790855658","19700425","804 BRIELLE COURT","SIMPSONVILLE","SC","29681","1128b4","20241120","00000000","00000000","" "KOOSHKABADI","ALI","","","PHYSICIAN (MD, DO)","NEUROLOGY","","1306078183","19820911","609 PONTE VILLAS N","BALTIMORE","MD","21230","1128b4","20241120","00000000","00000000","" "KOPENKIN","ALEXANDER","","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19860224","100 LONG POND ROAD","HEWITT","NJ","07421","1128a1","20241120","00000000","00000000","" "KUNZ","JOHN","DAVID","","PHYSICIAN (MD, DO)","SURGERY","","1649376351","19580228","101 W ARRELLAGA, STE B","SANTA BARBARA","CA","93101","1128b4","20241120","00000000","00000000","" "LAMB","PHILLIP","CHRISTOPHER","","IND- LIC HC SERV PRO","PHARMACIST","","1275046765","19900214","4313 BALINGTON DR","VALRICO","FL","33596","1128b4","20241120","00000000","00000000","" "LAUBHAN","CHRISTOPHER","MICHAEL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770710","3140 CLUB DR","TYLER","TX","75703","1128a3","20241120","00000000","00000000","" "LAWLEY","CATRINA","LONA","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19670523","122 OAK GROVE AVENUE","BRATTLEBORO","VT","05301","1128a1","20241120","00000000","00000000","" "LEARNED","DAVID","PAUL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19631204","1007 S MASON RD, APT 2606","KATY","TX","77450","1128b4","20241120","00000000","00000000","" "LEE","YUNG","CHENG","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19691118","1193 ALLIE COURT","MCKINLEYVILLE","CA","95519","1128b4","20241120","00000000","00000000","" "LEMELLE","WILLIEMAE","BUTLER PALMORE","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19620420","511 LEWIS ST, APT 2","SULPHUR","LA","70663","1128a1","20241120","00000000","00000000","" "LEVY","KELSEY","NICHOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920525","2436 WOODRUN TRAIL, APT 203","SPRINGDALE","AR","72764","1128b1","20241120","00000000","00000000","" "LEWIS","LINDA","DARNELL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19581202","1507 THORNHOLLOW DRIVE","HOUSTON","TX","77014","1128b4","20241120","00000000","00000000","" "LOLA","CALEB","NDELENGO","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19820716","536 ODLIN AVENUE","DAYTON","OH","45405","1128a1","20241120","00000000","00000000","" "LOMAX","CHRISTOPHER","DEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740728","2300 LA FORCE DR","MODESTO","CA","95355","1128b4","20241120","00000000","00000000","" "LONGIE","KELLY","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19821203","4472 BERRYKNOLL DR","COLORADO SPRINGS","CO","80916","1128b4","20241120","00000000","00000000","" "LOUIS","RHOMY","","","BUS OWNER/EXEC","UNIVERSITY/COLLEGE","","0000000000","19740502","4 COTTON TAIL COURT","SHIRLEY","NY","11967","1128a3","20241120","00000000","00000000","" "MACFARLANE","ALLYSON","LOREN","","IND- LIC HC SERV PRO","COUNSELOR","","1891171427","19910911","9231 S JEFFERSON CV, BLDG 9","SANDY","UT","84070","1128b4","20241120","00000000","00000000","" "MACIER","ETHAN","TYLER","","BUS OWNER/EXEC","LABORATORY","","0000000000","19990810","FPC MONTGOMERY","MONTGOMERY","AL","36112","1128a1","20241120","00000000","00000000","" "MADISON","JEFFREY","PAUL","","BUS OWNER/EXEC","HOSPITAL","","0000000000","19750202","201 DOVETAIL COVE","GEORGETOWN","TX","78628","1128a1","20240930","00000000","00000000","" "MAHAN","JAMIE","ESTELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900227","14542 INDIAN TRAILS CIR","DIBERVILLE","MS","39540","1128b4","20241120","00000000","00000000","" "MANIS","ANGELIQUE","LOLA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19771122","1665 SHADOW LANE","SPARKS","NV","89434","1128b4","20241120","00000000","00000000","" "MANNING","ROSHANDO","LATRICE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770828","525 TAYLOR AVE","BASTROP","LA","71220","1128a1","20241120","00000000","00000000","" "MANUEL","MICHELLE","L","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1215431861","19750811","10141 HIGHWAY 133","SHADY VALLEY","TN","37688","1128b4","20241120","00000000","00000000","" "MANZANO","RIADEL","H","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1386183572","19720419","10 OAKLEY LANE","EAST WILLISTON","NY","11596","1128a2","20241120","00000000","00000000","" "MARTIN","BENJAMIN","GEORGE SR","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1033579099","19651214","3786 EDGEWOOD DRIVE","BURTCHVILLE","MI","48059","1128b4","20241120","00000000","00000000","" "MARTIN","RHONDA","DRAPER HOLLAND","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19610119","93 STILLBROOK DRIVE","BASSETT","VA","24055","1128a2","20241120","00000000","00000000","" "MARYAN","RACHEL","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800425","1030 HARVEST HOME CIR","SAINT CHARLES","MO","63304","1128b4","20241120","00000000","00000000","" "MASON","MARKISHA","VARMANIA","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19821209","10489 HIGHWAY 71","ELM GROVE","LA","71051","1128a1","20241120","00000000","00000000","" "MATSUMURA","KENNETH","NAOYUKI","","PHYSICIAN (MD, DO)","ONCOLOGY","","1871610832","19450515","2705 WEBSTER STREET, UNIT 5885","BERKELEY","CA","94705","1128b4","20241120","00000000","00000000","" "MATTISON","EDDIE","B","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19470825","4629 SHORE DRIVE, APT 212","VIRGINIA BEACH","VA","23455","1128a1","20241120","00000000","00000000","" "MATTOS","JACQUELINE","F","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19700426","3924 SUNSET COVE DRIVE","PORT ORANGE","FL","32129","1128a3","20241120","00000000","00000000","" "MAULSON","KEVIN","DEAN","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","1093317901","19610911","11527 E STARKEY AVENUE","MESA","AZ","85212","1128a1","20241120","00000000","00000000","" "MCCLENDON","ASHLEY","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740705","218 PRIMROSE LANE","LEBANON","TN","37087","1128b4","20241120","00000000","00000000","" "MCCONKEY","JAMES","DAVID","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19681012","P O BOX 6639","KINGMAN","AZ","86402","1128b4","20241120","00000000","00000000","" "MCCORMAC","MICHAEL","J","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19670912","22 PLEASANT VALLEY DRIVE D","BALLWIN","MO","63021","1128a1","20241120","00000000","00000000","" "MCCULLOUGH","MARY","JEAN","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19660730","171 BIG V ROAD N","MOUNT OLIVE","MS","39119","1128a2","20241120","00000000","00000000","" "MCHUGH","LISA","ANN","","IND- LIC HC SERV PRO","CHIROPRACTIC","","1629134325","19640726","119 FREEPORT STREET","DELMONT","PA","15626","1128b4","20241120","00000000","00000000","" "MCINTOSH","CLIVE","OBRIAN","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","1396007688","19610605","7000 H C KELLEY ROAD","ORLANDO","FL","32831","1128a1","20241120","00000000","00000000","" "MCSHANE","SHANNON","KIMBERLY","","IND- LIC HC SERV PRO","PSYCHOLOGY","","1295298826","19670617","P O BOX 781462","SAN ANTONIO","TX","78278","1128b4","20241120","00000000","00000000","" "MERANDA","DAVID","RICHARD","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1811383102","19890307","P O BOX 540","SAINT CLAIRSVILLE","OH","43950","1128b4","20241120","00000000","00000000","" "MEYER","ALEXANDER","BRIAN","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1285671206","19730808","920 E SANTA PAULA STREET","SANTA PAULA","CA","93060","1128b4","20241120","00000000","00000000","" "MICHEL","RONY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19631213","P O BOX 2000","JOINT BASE MDL","NJ","08640","1128a3","20241120","00000000","00000000","" "MITCHELL","JOHN","FRANCIS","","PHYSICIAN (MD, DO)","PSYCHIATRY","","1316012347","19511125","2596 BRIDGETS WAY","ALLENTOWN","PA","18103","1128a4","20241120","00000000","00000000","" "MOINEAU","MEAGHAN","IRENE","","IND- LIC HC SERV PRO","COUNSELOR","","1255848172","19830125","4596 OTTAWA DR, UNIT 102","LAKE ORION","MI","48359","1128a2","20241120","00000000","00000000","" "MONGER","KICONYA","RENEE","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1518334770","19790509","16928 W MARCONI AVENUE","SURPRISE","AZ","85388","1128b4","20241120","00000000","00000000","" "MOORE","PETRA","SIOBHAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820606","11410 FILLMORE AVENUE","SEFFNER","FL","33584","1128b4","20241120","00000000","00000000","" "MOORE","TINA","DIONE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800830","1410 W CHESTNUT STREET","SAVANNAH","MO","64485","1128b4","20241120","00000000","00000000","" "MORGAN","NATHAN","MCLAIN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19771120","310 N 26TH STREET","WILMINGTON","NC","28405","1128b4","20241120","00000000","00000000","" "MORGAN","TRELESA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900725","2465 WOODMERE BLVD","HARVEY","LA","70058","1128b4","20241120","00000000","00000000","" "MORRIS","KENDALL","DAVID","","IND- LIC HC SERV PRO","PHARMACIST","","0000000000","19740426","8009 RIVERWOOD ESTATES PLACE","RIVERVIEW","FL","33569","1128b4","20241120","00000000","00000000","" "MOSES","KATHY","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19560508","1216 N 4TH AVE","EDINBURG","TX","78541","1128b4","20241120","00000000","00000000","" "MOZEE","PATTI","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640808","1141 ELM TREE COMMONS DR","MOSCOW MILLS","MO","63362","1128b4","20241120","00000000","00000000","" "MUNIZ","CARLOS","A SR","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1194871277","19661108","76 CALLE COLON","AGUADA","PR","00602","1128a1","20241120","00000000","00000000","" "MURPHY","KRISTINE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19681016","6486 DIANA DR, APT 5","YOUNGSTOWN","OH","44514","1128b4","20241120","00000000","00000000","" "MURPHY","NICHOLAS","TYLER","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19960523","115 E ALTURAS ST, APT 9","TUCSON","AZ","85705","1128a1","20241120","00000000","00000000","" "NAGSHSBANDI","SHAHRAM","N","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19690825","6905 TAMERON TRAIL","FORT WORTH","TX","76132","1128b7","20241009","00000000","00000000","" "NGOYA","REGINA","WANJIRU","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1073382735","19740916","1300 SW CAMPUS DR, APT 65-4","FEDERAL WAY","WA","98023","1128b4","20241120","00000000","00000000","" "NORMATOV","ALBERT","","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19751128","54 EVERIT AVENUE","HEWLETT","NY","11557","1128a1","20241120","00000000","00000000","" "ODEBUNMI","OLADIPO","","","EMPLOYEE - PRIVATE S","ADULT HOME","","0000000000","19831231","91 MCCABE AVENUE","PAWTUCKET","RI","02861","1128a2","20241120","00000000","00000000","" "OGUNSUSI","RAPHAEL","","","IND- LIC HC SERV PRO","PHARMACIST","","1881943793","19520926","P O BOX 1000","BUTNER","NC","27509","1128a4","20241120","00000000","00000000","" "OJUKWU","YVONNE","NDIDI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19760510","13725 CHADRON AVE, APT 233","HAWTHORNE","CA","90250","1128b4","20241120","00000000","00000000","" "OKAGBUE","SAMUEL","TAGBO SR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19581029","424 TRAIL CLIFF WAY","FORT WORTH","TX","76131","1128b4","20241120","00000000","00000000","" "OLIVER","RICHARD","THOMAS JR","","IND- LIC HC SERV PRO","PHYSICIAN ASSISTANT","","1699000224","19521116","860 SE SENTRY DR","COLLEGE PLACE","WA","99324","1128b4","20241120","00000000","00000000","" "ONCHONGA","PETTY","NYANCHAMA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820602","8910 WHITE CORAL WAY","MIDDLETON","WI","53562","1128b4","20241120","00000000","00000000","" "ORR","LYNENA","R","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","1871095125","19820908","1266 MARQUIS CT, FL 1","SAINT LOUIS","MO","63137","1128a1","20241120","00000000","00000000","" "ORTIZ","DENISSE","BELMARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830410","150 JENNINGS DRIVE, APT E","LANCASTER","PA","17603","1128b4","20241120","00000000","00000000","" "ORTIZ","EUGENIO","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19840223","275 VILLAGE LN","MERIDEN","CT","06451","1128a1","20241120","00000000","00000000","" "OSBORNE","SHADI","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820529","3220 AURORA STREET","HALTOM CITY","TX","76117","1128b4","20241120","00000000","00000000","" "OSWALT","COURTNEY","","","EMPLOYEE - PRIVATE S","SKILLED NURSING FAC","","0000000000","19721108","102 SNEAD WAY, APT 1","STARKVILLE","MS","39759","1128b1","20241120","00000000","00000000","" "OTTEN","ALINE","KAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19600114","2716 N STATE ROAD 550","VINCENNES","IN","47591","1128b4","20241120","00000000","00000000","" "PAIGE","DOMINIQUE","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","1841835758","19860710","4424 MARTIN LUTHER KING, JR BL","CLEVELAND","OH","44105","1128a1","20241120","00000000","00000000","" "PATTERSON","BRITTANI","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920130","213 OAK STREET","WATERLOO","IL","62298","1128b4","20241120","00000000","00000000","" "PEARSON","CHARLES","EDWARD","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19841006","P O BOX 621","EPPS","LA","71237","1128a1","20241120","00000000","00000000","" "PENDLETON","MONIQUE","DEIDRE","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1497147318","19700331","109 BEECHWOOD CIR","PEARL","MS","39208","1128b4","20241120","00000000","00000000","" "PEREZ","SILVANA","MARIA","","INDIVIDUAL (UNAFFILI","RECRUITER/CAPPER","","1932754900","19790601","939 NW 97TH AVENUE, APT 108","MIAMI","FL","33172","1128a3","20241120","00000000","00000000","" "PEREZ-FIGUEROA","SAMUEL","","","IND- LIC HC SERV PRO","PSYCHOLOGY","","0000000000","19690219","P O BOX 1031","COLEMAN","FL","33521","1128a2","20241120","00000000","00000000","" "PERKS","HEATHER","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19770303","22400 NE 112TH STREET 6","LIBERTY","MO","64068","1128b4","20241120","00000000","00000000","" "PHILLIPS","JORDAN","MICHAEL","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19951206","258 CALHOUN STREET","ALDERSON","WV","24910","1128a2","20241120","00000000","00000000","" "PICKETT","CHANELL","MONIQUE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19890729","22411 BUTTERFIELD RD, APT 307","RICHTON PARK","IL","60471","1128a1","20241120","00000000","00000000","" "PINEDA","MHILLER","VERGARA","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","20000417","25302 ROMERA PLACE","LAKE FOREST","CA","92630","1128a2","20241120","00000000","00000000","" "PINES","MICHAEL","B","","IND- LIC HC SERV PRO","PSYCHOLOGY","","1891887691","19480814","P O BOX 879","AYER","MA","01432","1128a1","20241120","00000000","00000000","" "PINKARD","JEAN","MARIE","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1972970838","19570426","3200 GRANADA BLVD","KISSIMMEE","FL","34746","1128a4","20241120","00000000","00000000","" "PLANCE","DONALD","WAYNE","","PHYSICIAN (MD, DO)","ORTHOPEDICS","","1942318134","19531209","7835 HILLROSE STREET, APT 5","SUNLAND","CA","91040","1128a3","20241120","00000000","00000000","" "PLEASANT","TASHIUS","TARESE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19870717","1911 SADDLEBROOK DR, APT P123","MURFREESBORO","TN","37129","1128a3","20241120","00000000","00000000","" "POLLACK","LEE","S","","PHYSICIAN (MD, DO)","NEUROLOGY","","1588757462","19610620","39 PHILBROOK WAY","SPRING","TX","77382","1128b4","20241120","00000000","00000000","" "POWELL","AUSTIN","TAYLOR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920829","1585 TIMBERTOP STREET, APT 208","LANCASTER","OH","43130","1128b4","20241120","00000000","00000000","" "PUTNAM","CHRISTOPHER","G","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19850120","7408 SW 77TH STREET","REDMOND","OR","97756","1128a1","20241120","00000000","00000000","" "RAFF","BRIAN","GENE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790323","325 HARRISON STREET","ORCHARD","NE","68764","1128a4","20241120","00000000","00000000","" "RAMOS","EVEREDITH","","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19731010","P O BOX 1280","CABO ROJO","PR","00623","1128a1","20241120","00000000","00000000","" "RAMSEY","DAVLINA","MICHELLE","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1316135544","19800830","3236 ORCHARD GRASS ROAD","LEXINGTON","KY","40509","1128b4","20241120","00000000","00000000","" "RANDLE","MARCUS","JIMMY DEON","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19940205","828 WINDSOR DR NE","MAGEE","MS","39111","1128a2","20241120","00000000","00000000","" "RANDLES","SHAWN","RENAE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670115","1924 CREEKSTONE","KOKOMO","IN","46901","1128a4","20241120","00000000","00000000","" "RAY","JAMES","EWING","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19701106","P O BOX 1000","TALLADEGA","AL","35160","1128a1","20241120","00000000","00000000","" "RENWICK","DENISE","LEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19710707","135 TEEPLE AVENUE","DONORA","PA","15033","1128b4","20241120","00000000","00000000","" "RIDDLE","VALERIE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19771022","1050 S MATUBBA ST","ABERDEEN","MS","39730","1128b4","20241120","00000000","00000000","" "RILEY","DAVID","E JR","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19690904","5 APPLESAUCE LANE","WAPPINGERS FALLS","NY","12590","1128a1","20241120","00000000","00000000","" "ROBINS","JACOB","TYLER","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19970729","P O BOX 33028","SAINT PETERSBURG","FL","33733","1128b4","20241120","00000000","00000000","" "ROJAS","NESTOR","SALVADOR","","BUS OWNER/EXEC","LABORATORY","","0000000000","19750206","14929 SW 132ND AVE","MIAMI","FL","33186","1128a3","20241120","00000000","00000000","" "ROMANO","THOMAS","J","","PHYSICIAN (MD, DO)","RHEUMATOLOGY","","1902136443","19491126","30 GREENWOOD AVE","WHEELING","WV","26003","1128a4","20241120","00000000","00000000","" "ROSARE","SURI","ANNA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19771118","167 HUGHES ROAD","LUFKIN","TX","75901","1128b4","20241120","00000000","00000000","" "ROSAS","MELISSA","","","EMPLOYEE - PRIVATE S","DENTAL PRACTICE","","0000000000","19810319","268 HERNANDEZ STREET","CALEXICO","CA","92231","1128b2","20241120","00000000","00000000","" "ROSE","LYNSEY","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19950615","1344 W DANISH RED TRL","SAN TAN VALLEY","AZ","85143","1128b4","20241120","00000000","00000000","" "ROYDER","ALEXANDRA","","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19880422","806 N GENESEE AVENUE","LOS ANGELES","CA","90046","1128a1","20241120","00000000","00000000","" "RUCKER","BRANDON","LAURENCE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1538565130","19900710","205 HONEY LOCUST DRIVE","NORTH LAS VEGAS","NV","89031","1128b4","20241120","00000000","00000000","" "RUSH","ALFRED","IZELL III","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1699268441","19730305","5318 10TH AVENUE S","SAINT PETERSBURG","FL","33707","1128a4","20241120","00000000","00000000","" "SANDOVAL","ALBERT","JOSE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19690406","162 OAKVIEW DR","POTEET","TX","78065","1128b4","20241120","00000000","00000000","" "SANYARE","SAHRO","AHMED","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19811205","11801 POLK STREET NE","MINNEAPOLIS","MN","55434","1128a1","20241120","00000000","00000000","" "SASU","GLORIA","ASANTEWAH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1629660030","19780302","957 BROADWAY, APT 702","BAYONNE","NJ","07002","1128b4","20241120","00000000","00000000","" "SCHEXNIDER","KURT","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19591219","17450 INTERSTATE HIGHWAY 10,","VIDOR","TX","77662","1128b4","20241120","00000000","00000000","" "SCHOBERT","JASON","CHRISTOPHER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890504","3127 STATE HIGHWASY 148 S","HENRIETTA","TX","76365","1128a4","20241120","00000000","00000000","" "SCHULER","ELAGIO","RAJON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1912471871","19980819","9283 W ROCHELLE AVENUE","LAS VEGAS","NV","89147","1128b4","20241120","00000000","00000000","" "SENG","UKEAR","","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19800415","27241 122ND AVE SE","KENT","WA","98030","1128a1","20241120","00000000","00000000","" "SHANNON","TARA","","","EMPLOYEE - PRIVATE S","ADULT DAY CARE FACIL","","0000000000","19820923","4240 C D BANKS AVENUE","SAINT LOUIS","MO","63113","1128a1","20241120","00000000","00000000","" "SHAW","DONOVAN","LAMONTE II","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19980429","1974 COTTON PLANT RD","BATESVILLE","MS","38606","1128a2","20241120","00000000","00000000","" "SHEETS","CHADWICK","A","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19890324","60 MAIN STREET","MILTON","VT","05468","1128a1","20241120","00000000","00000000","" "SHELTON","LAMORRIS","","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19720220","1524 BUNBURY DRIVE","THOMPSONS STATION","TN","37179","1128b4","20241120","00000000","00000000","" "SIAO","DONALD","","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1861415374","19650120","2032 LAKE VISTA COURT","SAN JOSE","CA","95148","1128a4","20241120","00000000","00000000","" "SIMS","BRITTNEY","","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19820212","10 T BROWN LANE","PRENTISS","MS","39474","1128a2","20241120","00000000","00000000","" "SINGH","ANKITA","","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1265870935","19820620","2589 S PINNACLE DRIVE","CHANDLER","AZ","85286","1128a1","20241120","00000000","00000000","" "SINGLETON","CHRISTOPHER","JORDAN","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19981221","2621 LAKEWAY DR","SHREVEPORT","LA","71109","1128a2","20241120","00000000","00000000","" "SMITH","ANGELO","","","EMPLOYEE - PRIVATE S","CLINIC","","0000000000","19761218","P O BOX 1000","CUMBERLAND","MD","21501","1128a4","20241120","00000000","00000000","" "SMITH","DYLON","TERRY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19961212","938 PALM ROAD","BIG SANDY","TX","75755","1128b4","20241120","00000000","00000000","" "SMITH","EZEKIEL","TY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940206","8980 US HIGHWAY 271 N","POWDERLY","TX","75473","1128b4","20241120","00000000","00000000","" "SMITH","JULIE","A","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840818","81 YOUNGS ROAD","STAR LAKE","NY","13690","1128b4","20241120","00000000","00000000","" "SMITH","SHERRIE","CRAWFORD","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670628","1526 MILLWEE CREEK RD","PENDLETON","SC","29670","1128b1","20241120","00000000","00000000","" "SOLI","EASTER","I","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19780325","3535 S H STREET, APT 102","BAKERSFIELD","CA","93304","1128a1","20241120","00000000","00000000","" "SORIANO","CAROLYN","A","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19581102","2258 ALEXIAN DR","SAN JOSE","CA","95116","1128b4","20241120","00000000","00000000","" "SOSA","RODNEY","WAYNE","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1720041916","19671024","P O BOX 26020","BEAUMONT","TX","77720","1128a1","20241120","00000000","00000000","" "SPARKS","SARA","K","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19930619","1001 E 9TH ST, APT 7","TRENTON","MO","64683","1128a1","20241120","00000000","00000000","" "SPARKS","SHERYL","K","","INDIVIDUAL (UNAFFILI","RECIPT/BENEFICIARY","","0000000000","19680831","725 KUMLER ST","TRENTON","MO","64683","1128a1","20241120","00000000","00000000","" "STRUNA","DANET","MONIQUE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19831014","614 SUMMIT DRIVE, APT 14","RIVERTON","WY","82501","1128b4","20241120","00000000","00000000","" "STURGIS","JULIE","DENISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19630508","508 N CHERRY CIR","NIXA","MO","65714","1128b4","20241120","00000000","00000000","" "SULLIVAN","BAILEY","KRISTEN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880809","1531 POPLAR AVENUE, APT 38","MEMPHIS","TN","38104","1128b4","20241120","00000000","00000000","" "SULLIVAN","C","STAN","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1407129588","19560623","4853 W 1125 S","CEDAR CITY","UT","84720","1128b4","20241120","00000000","00000000","" "SURA","ANJANA","SAILESH","","PHYSICIAN (MD, DO)","PEDIATRICS","","1972530418","19491122","714 HAMPTON ROAD","ARCADIA","CA","91006","1128b4","20241120","00000000","00000000","" "SWEENEY","RACHEL","LEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801006","8839 W LAMAR ROAD","GLENDALE","AZ","85305","1128b4","20241120","00000000","00000000","" "SWORD","LAUREN","","","IND- LIC HC SERV PRO","CHIROPRACTIC","","1013266550","19860109","4600 N OAKLEY AVE","KANSAS CITY","MO","64117","1128a1","20241120","00000000","00000000","" "TEMPLE","CHARLES","JOVAN","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","0000000000","19841227","1688 S FALCON DRIVE","GILBERT","AZ","85295","1128a1","20241120","00000000","00000000","" "TERRY","TIFFANY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890102","254 HARMON STREET","DETROIT","MI","48202","1128b4","20241120","00000000","00000000","" "THOMPSON","JESSICA","NICOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19970729","1204 CAIN CEMETERY RD","LONGVIEW","TX","75602","1128b4","20241120","00000000","00000000","" "TINGWEI","SUSAN","ENGONWEI","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","1659634442","19770814","GLEN RAY ROAD, BOX A","ALDERSON","WV","24910","1128a1","20241120","00000000","00000000","" "TRIGGS","DENZEL","","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19930119","6195 SUMMER HILLS CIR, APT 2","MEMPHIS","TN","38134","1128a2","20241120","00000000","00000000","" "TRUJILLO","MIRANDA","YVONNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890905","4300 S LOWELL BLVD, APT A308","ENGLEWOOD","CO","80110","1128b4","20241120","00000000","00000000","" "TURKO","RYAN","S","","EMPLOYEE - PRIVATE S","SKILLED NURSING FAC","","0000000000","19830602","264 BILTON ROAD","SOMERS","CT","06071","1128a3","20241120","00000000","00000000","" "TUTER","TERRY","BRIAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19530526","4140 S JACKSON DRIVE, APT 205","INDEPENDENCE","MO","64057","1128b4","20241120","00000000","00000000","" "VO","TIEN","","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1891964904","19761110","2456 S CYPRESS DRIVE","EL CENTRO","CA","92243","1128b1","20241120","00000000","00000000","" "VON FELDMANN","DIETRICH","","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1346354917","19400428","7696 STONE BLUFF WAY","RENO","NV","89523","1128b4","20241120","00000000","00000000","" "VOSS","CATHY","JO","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19850103","8455 HIGHWAY AE","SULLIVAN","MO","63080","1128b4","20241120","00000000","00000000","" "WALKER","ERIC","ARLANO","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19651227","1176 S 10TH STREET, FL 2","PHILADELPHIA","PA","19147","1128a1","20241120","00000000","00000000","" "WALKER","MARTY","","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19891111","2954 BEASLEY DR","TUPELO","MS","38801","1128a2","20241120","00000000","00000000","" "WALLACE","JENNIFER","COLLEEN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19741208","2964 LASHMIT DRIVE","WINSTON SALEM","NC","27103","1128b4","20241120","00000000","00000000","" "WALLACE","TKEYAK","SHANAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920502","1948 CADDY CIRCLE, APT 311","FORT WORTH","TX","76140","1128a4","20241120","00000000","00000000","" "WALSH","ANDREW","LAWRENCE","","IND- LIC HC SERV PRO","ACUPUNCTURIST","","1902372121","19720118","1304 SERISSA COURT","ORLANDO","FL","32818","1128b4","20241120","00000000","00000000","" "WALTON","MARQUISHA","JULISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900214","1740 LOCUST STREET, APT B","NORTH LITTLE ROCK","AR","72114","1128b1","20241120","00000000","00000000","" "WARDLOW","CHIQUITA","NATASHA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19731207","1442 ULTRAMARINE LN","PUNTA GORDA","FL","33983","1128b4","20241120","00000000","00000000","" "WAUGH","GAYLE","SUZANNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19550526","1216A PEYTON CIRCLE","GREENVILLE","NC","27834","1128b4","20241120","00000000","00000000","" "WEST","ERICA","NICOLE","","BUS OWNER/EXEC","ADULT HOME","","1154874758","19880131","2243 MULSANNE DR","LITHONIA","GA","30058","1128a2","20241120","00000000","00000000","" "WEST","JENNA","BETH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19850425","55445 FORRESTER VALLEY LANE","GLENWOOD","IA","51534","1128a2","20241120","00000000","00000000","" "WEST","VALERIE","LA SHAN","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19650920","4425 MEMORIAL DRIVE","DECATUR","GA","30032","1128a2","20241120","00000000","00000000","" "WHALEN","BRIDGETT","K","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801205","917 33RD ST","TELL CITY","IN","47586","1128a4","20241120","00000000","00000000","" "WHITE","PAUL","ANTHONY","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19860419","90 ROWE HILL ROAD","HARTFORD","NY","12838","1128a2","20241120","00000000","00000000","" "WIDEMAN","JENNIFER","ELLEN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801019","416 CEDAR ST","HAWK POINT","MO","63349","1128b4","20241120","00000000","00000000","" "WILDER","ROBIN","CLAIRE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19950816","152 KEESLER CIR","BILOXI","MS","39530","1128b4","20241120","00000000","00000000","" "WILLEY","ADRIAN","GALE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660913","121 PARADISE CAMP ROAD","HARRODSBURG","KY","40330","1128b4","20241120","00000000","00000000","" "WILLIAMS","KELLIE","JOLENE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890121","1218 N MURRAY BLVD","COLORADO SPRINGS","CO","80915","1128b4","20241120","00000000","00000000","" "WILT","KATIE","ALLISON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19870316","7804 FOREST HILL AVE","RICHMOND","VA","23225","1128b4","20241120","00000000","00000000","" "WINSTON","JUNE","","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","0000000000","19571021","4011 BORDEAUX RIDGE CV N, APT","MEMPHIS","TN","38125","1128a3","20241120","00000000","00000000","" "WITHERSPOON","STANTON","A","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1588964316","19750504","200 MILL ROAD","BURLINGTON","NJ","08016","1128a3","20241120","00000000","00000000","" "WOOD","BROOKE","ELIZABETH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940725","2933 N KINGSHIGHWAY ST","PERRYVILLE","MO","63775","1128b4","20241120","00000000","00000000","" "WORTHEN","JEWELL","DENISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19570628","1025 MCNAMEE STREET, APT C","LEESBURG","FL","34748","1128b4","20241120","00000000","00000000","" "YAMAGUCHI","SHUICHI","","","IND- LIC HC SERV PRO","DENTIST","","1790883650","19520816","6113 ST ANDREWS DRIVE","MUKILTEO","WA","98275","1128b4","20241120","00000000","00000000","" "YARDLEY","ASHLEY","NICHOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840628","1971 S 2660 E , UNIT E","SAINT GEORGE","UT","84790","1128a4","20241120","00000000","00000000","" "YOUNG","JEFFREY","W JR","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1205879764","19730909","P O BOX 14500","LEXINGTON","KY","40512","1128a4","20241120","00000000","00000000","" "ZOLOTUSKIY","EUGENE","","","BUS OWNER/EXEC","CHECK CASHING STORE","","0000000000","19800917","29 AZALEA DRIVE","SYOSSET","NY","11791","1128a3","20241120","00000000","00000000",""