LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"","","","ARAMINGO PHARMACY","OTHER BUSINESS","PHARMACY","","1164994307","","2313 E VENANGO STREET, STE 1A","PHILADELPHIA","PA","19134","1128a1","20240320","00000000","00000000",""
"","","","DR LOKESH S TANTUWAYA MD INC","PHYSICIAN PRACTICE (","NEUROLOGY","","1114939659","","7830 CLAIREMONT MESA BLVD","SAN DIEGO","CA","92111","1128b8","20240320","00000000","00000000",""
"","","","LABTOX, LLC","OTHER BUSINESS","LABORATORY","","1235576398","","2716 OLD ROSEBUD ROAD, STE 280","LEXINGTON","KY","40509","1128b7","20240202","00000000","00000000",""
"ADEPOJU","ADEOLU","A","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19840531","1021 ASHLAND ST","MIDDLETOWN","DE","19709","1128a2","20240320","00000000","00000000",""
"AICE","TERRANCE","","","EMPLOYEE - PRIVATE S","PHARMACY","","0000000000","19720925","P O BOX 15330","FORT WORTH","TX","76119","1128a3","20240320","00000000","00000000",""
"AJAJA","STACEY","NGOZI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19700913","20614 RUSTIC HEARTH CT","RICHMOND","TX","77407","1128a1","20240320","00000000","00000000",""
"ALAMUR","GILBERT","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640322","24 DEWEY RD","CHELTENHAM","PA","19012","1128b4","20240320","00000000","00000000",""
"ALEXANDER","LAWRENCE","MICHAEL","","PHYSICIAN (MD, DO)","ORTHOPEDICS","","1912128851","19770803","P O BOX 725","EDGEFIELD","SC","29824","1128a1","20240320","00000000","00000000",""
"ALMEIDA","OSCAR","DOMINGO JR","","PHYSICIAN (MD, DO)","GYN/OBS","","1003939471","19550804","7009 CHARLESTON OAKS DR UNIT 2","MOBILE","AL","36695","1128b4","20240320","00000000","00000000",""
"ALVAREZ","JESUS","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19711013","4113 KNOXVILLE AVE","LAKEWOOD","CA","90713","1128a3","20240320","00000000","00000000",""
"ALVAREZ","JOSE","LUIS","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19871123","8127 E LONG MESA DRIVE, APT B","PRESCOTT VALLEY","AZ","86314","1128a1","20240320","00000000","00000000",""
"AMIN","MELCHIADES","ASONFGUA","","EMPLOYEE - PRIVATE S","BILLING SERVICE CO","","0000000000","19771216","11303 SPRING PARK COURT","GLENN DALE","MD","20769","1128a1","20240320","00000000","00000000",""
"ANDERSON","GABRIEL","MONIQUE","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19890516","1938 N AVENIDA DE PALMAS, UNIT","CASA GRANDE","AZ","85122","1128a1","20240320","00000000","00000000",""
"ANTLE","DAWN","RENEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1518181098","19620205","624 DENTON AVENUE","SELLERSBURG","IN","47172","1128a1","20240320","00000000","00000000",""
"APPOLON","VANELIE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1164912382","19830320","2916 EASTERN BLVD","BALDWIN","NY","11510","1128b4","20240320","00000000","00000000",""
"ARMSTRONG","MARCUS","ORLANDO","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19661116","PO BOX 1027","COLEMAN","FL","33521","1128a3","20240320","00000000","00000000",""
"ATOYAN","AKOP","","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19721129","PO BOX 5000","SHERIDAN","OR","97378","1128a1","20240320","00000000","00000000",""
"BABALOLA","FLORENCE","","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19670927","8922 SNYDER FARM LANE","RICHMOND","TX","77469","1128a1","20240320","00000000","00000000",""
"BAKER","ERICA","","","EMPLOYEE - PRIVATE S","LABORATORY-IDTF","","0000000000","19920304","157 PALISADES POINT","LANCASTER","KY","40444","1128a1","20240130","00000000","00000000",""
"BALDWIN","SHELBY","","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19911216","36  COUNTY ROAD 330","CORINTH","MS","38834","1128b4","20240320","00000000","00000000",""
"BANKHEAD","ALEX","SPENCE","","IND- LIC HC SERV PRO","DENTIST","","1316029002","19670327","1375 E 800, N","OREM","UT","84097","1128b4","20240320","00000000","00000000",""
"BANKS","HYZEEM","KASHAWN","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19970216","2643 W OAKDALE STREET","PHILADELPHIA","PA","19132","1128a1","20240320","00000000","00000000",""
"BARNHART","ROBIN","RUMSEY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19651001","54046 LISA DRIVE","CALLAHAN","FL","32011","1128b4","20240320","00000000","00000000",""
"BARRAS","JONATHAN","DRISKILL","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1659394674","19630610","2824 N ASHECROFT DRIVE","EDMOND","OK","73034","1128b3","20240320","00000000","00000000",""
"BARTZ","HOWARD","JAY JR","","BUS OWNER/EXEC","DME - ORTHOTICS","","0000000000","19720514","600 HARRIS ROAD","SONOMA","CA","95476","1128a1","20240320","00000000","00000000",""
"BAZILE LECORPS","BETINA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880218","676 THOMAS AVENUE","BALDWIN","NY","11510","1128b4","20240320","00000000","00000000",""
"BEAM","OLIVIA","PAIGE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1720612096","19930603","9808 ORLANDI COURT","LOUISVILLE","KY","40299","1128b4","20240320","00000000","00000000",""
"BECK","ERIC","","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1740238112","19590122","2210 TOLL GATE ROAD SE","HUNTSVILLE","AL","35801","1128a1","20240320","00000000","00000000",""
"BEG","AMIR","ZAMIR","","IND- LIC HC SERV PRO","DENTIST","","1992203707","19850724","8501 HAMPTON SPRINGS ROAD","PERRY","FL","32348","1128b4","20240320","00000000","00000000",""
"BELLAMY","CURTIS","LEON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19621221","500 WATERSCAPE WAY","ORLANDO","FL","32828","1128b4","20240320","00000000","00000000",""
"BENDELSTEIN","HAROLD","L","","PHYSICIAN (MD, DO)","OTORHINOLARYNGOLOGY","","1154487676","19510323","463 BEACH 6TH STREET","FAR ROCKAWAY","NY","11691","1128a1","20240320","00000000","00000000",""
"BENDER","JAY","","","PHYSICIAN (MD, DO)","PAIN MANAGEMENT","","1235237546","19660714","P O BOX 1000","TALLADEGA","AL","35160","1128a3","20240320","00000000","00000000",""
"BENTLEY","KELSI","JAYNE","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19970909","7114 E THRUSH LANE, APT 2","PRESCOTT VALLEY","AZ","86314","1128a1","20240320","00000000","00000000",""
"BERNDT","KERRI","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19760429","305 CENTER STREET","MIDDLETOWN","IA","52638","1128b4","20240320","00000000","00000000",""
"BERRO","SUZAN","","","EMPLOYEE - PRIVATE S","PHARMACY","","1306470315","19990129","6001 ORCHARD AVE","DEARBORN","MI","48126","1128a3","20240320","00000000","00000000",""
"BESONG","MBENG","CECILIA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1700143773","19850521","1003 HORSE COLLAR ROAD","ACCOKEEK","MD","20607","1128b4","20240320","00000000","00000000",""
"BICKER","JESSICA","NICOLE","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19920930","2445 CAPELLA COURT","CHINO VALLEY","AZ","86323","1128a1","20240320","00000000","00000000",""
"BISHOP","BRANDON","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740814","1601 CHAMBERS ST","VICKSBURG","MS","39180","1128b4","20240320","00000000","00000000",""
"BLANKENSHIP","EDWARD","GORDON JR","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19520425","1336 E WALNUT STREET","HANOVER","PA","17331","1128b4","20240320","00000000","00000000",""
"BOSKET","AISHA","KHADIJAH","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19900905","902 VALLEY ROAD,  APT 25D","ELKINS PARK","PA","19027","1128a1","20240320","00000000","00000000",""
"BOZHKO","EDUARD","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19720518","3617 FORDS LANE","BALTIMORE","MD","21215","1128a1","20240320","00000000","00000000",""
"BRADLEY","CHRISTOPHER","D","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860207","4402 WESTWOOD PARK DRIVE","SHREVEPORT","LA","71109","1128a2","20240320","00000000","00000000",""
"BRADLEY","RODERICK","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19821212","2522 BRIDGE ROAD","BUCKINGHAM","VA","23921","1128a1","20240320","00000000","00000000",""
"BRADLEY","ROSA","","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19670214","3637 SOUTHLAND DR","JACKSON","MS","39212","1128a2","20240320","00000000","00000000",""
"BRASE","VICTORIA","MAE","","IND- LIC HC SERV PRO","COUNSELOR","","1851962609","19810703","5014 S 300TH PL, UNIT 1","AUBURN","WA","98001","1128b4","20240320","00000000","00000000",""
"BRIL","HANNAH","NICOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840611","2022 SHELENE WAY","FOLEY","AL","36535","1128b4","20240320","00000000","00000000",""
"BROWN","DAWN","CHARISSE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19701031","2951 NW 164TH STREET","OPA LOCKA","FL","33054","1128b4","20240320","00000000","00000000",""
"BROWNE","NOAH","DAVID","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19881204","24541 SW 114TH PLACE","HOMESTEAD","FL","33032","1128b4","20240320","00000000","00000000",""
"BRYAN","STACEY ANN","LATOYA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810828","3547 GREAT NECK ROAD, APT 59D","AMITYVILLE","NY","11701","1128b4","20240320","00000000","00000000",""
"BUCCI","ROBERT","EUGENE JR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1871823732","19661211","621 ELM DRIVE,  APT 1","VERONA","PA","15147","1128b4","20240320","00000000","00000000",""
"BUNYAD","DARIUS","","","IND- LIC HC SERV PRO","CHIROPRACTIC","","1528290392","19800903","2777 VENTURA AVENUE","SANTA ROSA","CA","95403","1128a2","20240320","00000000","00000000",""
"BURGION","EDGAR","GOMEZ","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730407","20810 31ST LANE S, APT B","SEATAC","WA","98198","1128a2","20240320","00000000","00000000",""
"BURTNER","CHRISTY","LINN","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19730914","31123 OLD SANTIAM HWY","LEBANON","OR","97355","1128a1","20240320","00000000","00000000",""
"CABE","KENDRA","N","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820419","1312 JOHN BURCH RD","DUNLAP","TN","37327","1128b4","20240320","00000000","00000000",""
"CAROSELLI","LAINE","RUTH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19651117","11 BLUEBIRD TERRACE","CASTLETON ON HUDSON","NY","12033","1128a3","20240320","00000000","00000000",""
"CARRERA","LATONJA","D","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","0000000000","19740425","5406 WOODYARD ROAD","UPPER MARLBORO","MD","20772","1128a3","20240320","00000000","00000000",""
"CARROLL","MISTY","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19741210","817 VILLAGE ROAD","KENNEDY","AL","35574","1128b4","20240320","00000000","00000000",""
"CARSTENSEN","CODY","DAVID","","IND- LIC HC SERV PRO","PHARMACIST","","1508969569","19760514","45594 296TH ST","WAKONDA","SD","57073","1128a4","20240320","00000000","00000000",""
"CARTER","JENNIFER","LAUREN","","INDIVIDUAL (UNAFFILI","RECRUITER/CAPPER","","0000000000","19840917","2150 BENTWORTH DRIVE, APT 384","HOUSTON","TX","77077","1128a1","20240320","00000000","00000000",""
"CARTER BURNELL","ROXANNE","YVETTE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19680124","315 E ADAMS STREET","LONG BEACH","CA","90805","1128a1","20240320","00000000","00000000",""
"CHAPMAN","GERMAINE","GUEST","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19580718","1548 WATOGA WAY","MOUNT PLEASANT","SC","29466","1128b4","20240320","00000000","00000000",""
"CHAPMAN","KATHERINE","PAIJE","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19961215","1630 E CENTER STREET","CHINO VALLEY","AZ","86323","1128a1","20240320","00000000","00000000",""
"CHAPMAN","MOLLY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820722","219 COUNTY ROAD 336","OKOLONA","MS","38860","1128a3","20240320","00000000","00000000",""
"CHARLES","KEVIN","","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19900921","118 E 144TH AVENUE","TAMPA","FL","33613","1128b4","20240320","00000000","00000000",""
"CHEATHAM","MARY","NICOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800609","GLEN RAY ROAD, BOX A","ALDERSON","WV","24910","1128a3","20240320","00000000","00000000",""
"CHINYAMA","IVONNE","TENDAI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19781121","8524 ALICIA STREET, APT 1ST","PHILADELPHIA","PA","19111","1128b4","20240320","00000000","00000000",""
"CHRISTIAN","WENDY","LEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19780114","668 COUNTY ROAD 1396","CHICKASHA","OK","73018","1128a2","20240320","00000000","00000000",""
"CHRISTOPHERSON","MITCHELL","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1649524109","19850806","P O BOX 143","DUNSEITH","ND","58329","1128b4","20240320","00000000","00000000",""
"CLARIDA","SHAWNEE","ANDREA","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19960520","199 SOUTHERN PINES ROAD","SANTA ROSA BEACH","FL","32459","1128a1","20240320","00000000","00000000",""
"CLARKE","QUANTARA","LEEONETTER","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","1255563532","19720406","P O BOX 734","MIDWAY","FL","32343","1128a1","20240320","00000000","00000000",""
"CLEA","MELISSA","WILSON","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19690117","5494 MARSALA LANE,  APT 302","JACKSONVILLE","FL","32244","1128a1","20240320","00000000","00000000",""
"COBURN","RONALD","HOWARD","","BUS OWNER/EXEC","LABORATORY","","0000000000","19470124","3000 BOBWHITE TRAIL","LEXINGTON","KY","40509","1128a1","20240202","00000000","00000000",""
"COLLINS","MILTON","C JR","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1548372592","19490720","1905 S WESTMORELAND DRIVE","ORLANDO","FL","32805","1128b4","20240320","00000000","00000000",""
"COLLINS","PATRICIA","MARSHA","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19640521","987 63RD STREET, APT 2","EMERYVILLE","CA","94608","1128a1","20240320","00000000","00000000",""
"COMPSON","SHERADRI","ANN","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19721117","3975 N CONSTANCE DRIVE","PRESCOTT VALLEY","AZ","86314","1128a1","20240320","00000000","00000000",""
"CONE","JOSEPH","EMMITT","","EMPLOYEE - PRIVATE S","SKILLED NURSING FAC","","0000000000","19820226","485 GEORGE CONE RD","LUCEDALE","MS","39452","1128a2","20240320","00000000","00000000",""
"COOPER","RACHEL","WEDE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19620621","4854 AMBER VALLEY PKWY S","FARGO","ND","58104","1128a2","20240320","00000000","00000000",""
"COPAS","KELIE","FAYE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860618","188 BANCROFT CHAPEL RD","KINGSPORT","TN","37660","1128b4","20240320","00000000","00000000",""
"CORLEY","WILLIAM","DANIEL II","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","20000729","1085 ATLANTIC BOULEVARD, APT 8","ATLANTIC BEACH","FL","32233","1128b4","20240320","00000000","00000000",""
"COX","ERIC","DONZEL SR","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19710401","1430 SUMMIT AVE","SAINT PAUL PARK","MN","55071","1128a1","20240320","00000000","00000000",""
"COX","SALLY","RIGGS","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19630215","361 OSENIDER ROAD","FRANKLIN","PA","16323","1128b4","20240320","00000000","00000000",""
"CROSSLEY","JACKIE","NICOLE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19740929","3341 CHESTER LANE","BAKERSFIELD","CA","93309","1128a1","20240320","00000000","00000000",""
"CROY","BROOKE","C L","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19891121","1635 N TOPAZ ROAD","PRESCOTT","AZ","86301","1128a1","20240320","00000000","00000000",""
"CURBO","CHELSEA","ELISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880930","1720 VIA MESA","SAN LORENZO","CA","94580","1128b4","20240320","00000000","00000000",""
"D'ANJOU","TANYA","LAUR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19750104","624 FIG STREET","SCRANTON","PA","18505","1128b4","20240320","00000000","00000000",""
"DARDIS","CAITLIN","RUTH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920129","1154 N 9TH STREET, FRONT A","READING","PA","19604","1128b4","20240320","00000000","00000000",""
"DAUCH","JOSEPH","GEORGE","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19750405","P O BOX 779800","MIAMI","FL","33177","1128a1","20240320","00000000","00000000",""
"DAVIS","HOWARD","","","EMPLOYEE - PRIVATE S","ADULT HOME","","0000000000","19620918","4366 REDWOOD CIRCLE","JACKSON","MS","39212","1128a2","20240320","00000000","00000000",""
"DAVIS","KRISTIN","MARIE","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19860319","131 IONE AVE","HILL CITY","MN","55748","1128a1","20240320","00000000","00000000",""
"DAVIS","SCOTT","OWEN","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1790987881","19610505","8378 W GRANDRIDGE BLVD, APT 11","KENNEWICK","WA","99336","1128a2","20240320","00000000","00000000",""
"DEBERNARDO","KELLY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820712","19118 E SUPERSTITION CT","QUEEN CREEK","AZ","85142","1128b4","20240320","00000000","00000000",""
"DEVITO","JACQUELYN","MARIE","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1073951000","19820421","GLEN RAY ROAD, BOX  A","ALDERSON","WV","24910","1128a3","20240320","00000000","00000000",""
"DRAKE","DANIELA","","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1922134907","19631110","176 WATERMILL LANE","LEBANON","TN","37087","1128a1","20240320","00000000","00000000",""
"DUARTE","RENATO","F","","PHYSICIAN (MD, DO)","PSYCHIATRY","","1902935208","19591219","PO BOX 1000","WHITE DEER","PA","17887","1128a1","20240320","00000000","00000000",""
"DUCKSWORTH","LATESHIA","","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19780904","46 COUNTY ROAD 1682","LOUIN","MS","39338","1128a2","20240320","00000000","00000000",""
"DUNCANSON","SARAH","MARIE","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19921130","3571 N VALORIE DRIVE","PRESCOTT VALLEY","AZ","86314","1128a1","20240320","00000000","00000000",""
"EAGLE","ANDREA","MICHELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19760427","14568 W AVALON DRIVE","GOODYEAR","AZ","85395","1128b4","20240320","00000000","00000000",""
"EASTIS","ERIN","MICHELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19850129","3074 TERESA AVE","BESSEMER","AL","35023","1128b4","20240320","00000000","00000000",""
"EDMOND","GREGORY","DALE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19970514","1601 HOGAN LANE,  APT 2009","CONWAY","AR","72034","1128b1","20240320","00000000","00000000",""
"ELMER","HEIDI","JUNE","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19810523","4775 N COLUMBINE DRIVE","PRESCOTT VALLEY","AZ","86314","1128a1","20240320","00000000","00000000",""
"EMTER","TERA","J","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19781027","311 N 12TH ST","BISMARCK","ND","58501","1128b4","20240320","00000000","00000000",""
"ERKS","JESSICA","LYNN","","EMPLOYEE - PRIVATE S","OPTICAL PRACTICE","","0000000000","19861227","P O BOX 10221","PRESCOTT","AZ","86304","1128a1","20240320","00000000","00000000",""
"ESKEW","ASHLEY","J","","EMPLOYEE - ST/LOC/TR","STATE GOV'T","","0000000000","19910610","303 INDIANAPOLIS AVE","LEBANON","IN","46052","1128b1","20240320","00000000","00000000",""
"EVANS","CAITLIN","ASHLEY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19851016","6015 APRIL LN","MISSOULA","MT","59803","1128a4","20240320","00000000","00000000",""
"EZEANYA","OBIAGELI","","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1992269146","19710919","6481 ROYAL POINTE DRIVE","WEST BLOOMFIELD","MI","48322","1128a1","20240320","00000000","00000000",""
"EZIDORE","LESLIE","ANDRE","","INDIVIDUAL (UNAFFILI","RECRUITER/CAPPER","","0000000000","19700205","3600 GUARD RD","LOMPOC","CA","93436","1128a3","20240320","00000000","00000000",""
"FAGELMAN","TRICIA","KAY","","EMPLOYEE - PRIVATE S","OPTOMETRIC PRACTICE","","0000000000","19910327","4920 N MINER ROAD","PRESCOTT VALLEY","AZ","86314","1128a1","20240320","00000000","00000000",""
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"WOOD","SANDRA","LEA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19710512","505 E DOMINICK STREET, APT 1","ROME","NY","13440","1128b4","20240320","00000000","00000000",""
"WORTHY","JOSALYNE","GABRI-ANNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19941024","1746 WASHINGTON BLVD","MOUNT DORA","FL","32757","1128b4","20240320","00000000","00000000",""
"WRIGHT","JAMES","ALBERT III","","IND- LIC HC SERV PRO","PHARMACIST","","0000000000","19810312","4250 HAWS COURT, UNIT 2","ORLANDO","FL","32814","1128b4","20240320","00000000","00000000",""
"WRIGHT","PAMELA","P","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19850730","3332 E LATIMER PLACE","TULSA","OK","74115","1128a4","20240320","00000000","00000000",""
"YOUSUF","ESKENDER","M","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19820101","P O BOX 1000","DULUTH","MN","55814","1128a1","20240320","00000000","00000000",""