LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"","","","JANETTE J GRAY M D, INC","PHYSICIAN PRACTICE (","INTERNAL MEDICINE","","1609177294","","3636 FIFTH AVENUE, STE 300","SAN DIEGO","CA","92103","1128b7","20241007","00000000","00000000",""
"","","","LAFFERTY ENTERPRISES, INC","OTHER BUSINESS","AMBULANCE COMPANY","","1558356444","","C/O PAUL ALLEN LAFFERTY","PRESTONSBURG","KY","41653","BRCH SA","20241106","00000000","00000000",""
"ABAZIED COGAR","JOY","GAYLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670405","101 DEE ST","ARP","TX","75750","1128b4","20241219","00000000","00000000",""
"AGUSTIN","ERNESTO","AQUINO","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640926","5770 CLOVER GROFF DR","HILLIARD","OH","43026","1128a2","20241219","00000000","00000000",""
"AGUSTSSON","THORDUR","SKULI","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1790895977","19530803","1150 J WILL STEWART ROAD","RUSSELLVILLE","KY","42276","1128b4","20241219","00000000","00000000",""
"AHMED","TAMER","IBRAHIM","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19770104","147 CROWN POINTE DR","YORK","PA","17402","1128b4","20241219","00000000","00000000",""
"ALEXANDRE","JASON","MELCHIS","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1477988954","19891129","P O BOX 247","PHOENIX","MD","21131","1128a1","20241219","00000000","00000000",""
"ALFONSI","JOY","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19750208","11 BEAVER RUN DRIVE","QUAKERTOWN","PA","18951","1128a2","20241219","00000000","00000000",""
"ALSTON","SY-AJAH","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19981106","321 CHARRING CROSS DRIVE","DOVER","DE","19904","1128a2","20241219","00000000","00000000",""
"ANDERSON","BRENDA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19510126","2676 S WOODLOCH ST","CONROE","TX","77385","1128b4","20241219","00000000","00000000",""
"ANDREWS","MAURICE","","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","1003188111","19850622","8530 N 22ND AVENUE, APT 2116","PHOENIX","AZ","85021","1128a1","20241219","00000000","00000000",""
"ARMITAGE","DESMOND","JOSEPH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19871004","12143 SITKA ST","EL MONTE","CA","91732","1128b4","20241219","00000000","00000000",""
"ARMSTRONG","MELANIE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19910922","6626 BEVERLY DRIVE","CLEVELAND","OH","44130","1128a3","20241219","00000000","00000000",""
"ASEJO","ESTRELLA","PINEDA","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1801007588","19440928","3946 S SILVER OAK WAY","ONTARIO","CA","91761","1128a1","20241219","00000000","00000000",""
"AVANT","DAMMIE","","","EMPLOYEE - PRIVATE S","ADULT HOME","","0000000000","19801227","712 E ALSTON AVE","MEMPHIS","TN","38126","1128a2","20241219","00000000","00000000",""
"BACHIR","AHMED","M","","IND- LIC HC SERV PRO","PHARMACIST","","1720443674","19910612","1070 MORRIS AVENUE, APT 1224","UNION","NJ","07083","1128b4","20241219","00000000","00000000",""
"BAKER","TRACI","DANIELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1881091395","19700516","12435 LOLA DR","SPRING HILL","FL","34608","1128b4","20241219","00000000","00000000",""
"BANKS","KEISHA","CARROLL","","EMPLOYEE - PRIVATE S","SKILLED NURSING FAC","","0000000000","19720307","512 GREY MARE COURT","LEXINGTON","SC","29072","1128a3","20241219","00000000","00000000",""
"BARRAZA","ROBERT","A","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19891026","3209 VOGUE DR","EL PASO","TX","79935","1128b4","20241219","00000000","00000000",""
"BARRERA","LAURA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19901106","210 W FANNIN ST","REFUGIO","TX","78377","1128a3","20241219","00000000","00000000",""
"BEE","LEE","PETER","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1669429908","19731013","411 AVALON CHASE DRIVE","FENTON","MO","63026","1128a1","20241219","00000000","00000000",""
"BEKHIT","CHRISTINA","","","IND- LIC HC SERV PRO","PHARMACIST","","1952616922","19850509","9 PEGGY ROAD","EAST BRUNSWICK","NJ","08816","1128a3","20241219","00000000","00000000",""
"BELL","JEFFREY","LYNN","","IND- LIC HC SERV PRO","TECHNICIAN","","0000000000","19770608","3449 S W STATE ROAD 26","TRENTON","FL","32693","1128b4","20241219","00000000","00000000",""
"BENDER","HAYDEN","HENDERSON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19960202","99 TERRY ST","SPRINGVILLE","AL","35146","1128b4","20241219","00000000","00000000",""
"BENJAMIN","TAJHMON","SHUJUAN","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19990901","67 ESSIE ST","ALEXANDRIA","LA","71301","1128a2","20241219","00000000","00000000",""
"BETTS","CHARLES","EDWARD JR","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","20000508","2350 ATASCOCITA ROAD","HUMBLE","TX","77396","1128a2","20241219","00000000","00000000",""
"BETTS","PATRICIA","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19740402","742 FM 712","MARLIN","TX","76661","1128a2","20241219","00000000","00000000",""
"BICKLEY","LISA","LOUISE","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19640708","5335 NOBLE CIR S","JACKSONVILLE","FL","32211","1128b4","20241219","00000000","00000000",""
"BIGGS","SHALIS","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1780341875","19710520","1970 JAMES FARM RD","STRATFORD","CT","06614","1128b4","20241219","00000000","00000000",""
"BOLDEN","BRENDA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19540703","11 WATKINS STREET","BAY SPRINGS","MS","39422","1128a2","20241219","00000000","00000000",""
"BONITO","RODERICK","J","","INDIVIDUAL (UNAFFILI","RECRUITER/CAPPER","","0000000000","19781008","27 W 1ST STREET, APT 205","BAYONNE","NJ","07002","1128a3","20241219","00000000","00000000",""
"BRANCH","KRISTINA","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19690120","3529 DOMINION AVE, UNIT A","NORFOLK","VA","23518","1128a1","20241219","00000000","00000000",""
"BRIGHT","AMBER","L","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","1043583321","19680126","1378 RED TAIL HAWK DR","YOUNGSTOWN","OH","44512","1128a1","20241219","00000000","00000000",""
"BRIZENDINE","BUFFY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19760826","12884 NEWTOWN RD","NEWTOWN","VA","23126","1128a1","20241219","00000000","00000000",""
"BROOKS","JENNIFER","L","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19710609","145 WILLOWSHORE DRIVE, APT 6","SCOTTSBURG","IN","47170","1128a4","20241219","00000000","00000000",""
"BROWN","GINGER","BRINKER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19620723","114 GIBSON STREET","DRUMRIGHT","OK","74030","1128b4","20241219","00000000","00000000",""
"BROWN","ROBERT","GEORGE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19520116","9749 BIRCHBROOK CT, APT J306","IRWIN","PA","15642","1128a1","20241219","00000000","00000000",""
"BROWN","TARA","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19720711","633 SMITH ROAD","NUNNELLY","TN","37137","1128b4","20241219","00000000","00000000",""
"BROWN-CLARK","JACQUELINE","E","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19690907","543 MIDDLESEX DRIVE","MIDDLETOWN","DE","19709","1128a2","20241219","00000000","00000000",""
"BUTLER-MARTIN","LATORA","CRYSTAL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880410","5013 N 12TH STREET, APT 2","PHILADELPHIA","PA","19141","1128a4","20241219","00000000","00000000",""
"CALDERON","MICHAEL","FREDERICK","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19881222","3505 BRISTLEWOOD COURT, APT 20","WINTER PARK","FL","32792","1128a2","20241219","00000000","00000000",""
"CAMUS","PABLO","GARCES","","BUS OWNER/EXEC","DME - ORTHOTICS","","0000000000","19561230","6821 FALCONSGATE AVENUE","DAVIE","FL","33331","1128a1","20241219","00000000","00000000",""
"CAMUS","SHANE","PAUL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940215","7549 NW 117TH LANE","PARKLAND","FL","33076","1128a1","20241219","00000000","00000000",""
"CANNON","WINDY","GALE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790824","2605 CHARITY LN, UNIT D","HAZEL GREEN","AL","35750","1128b4","20241219","00000000","00000000",""
"CARROLL","BRIAHNA","DELORES","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19941119","2507 MINNESOTA AVENUE,  APT D","LYNN HAVEN","FL","32444","1128a3","20241219","00000000","00000000",""
"CARROLL","ROBERT","MICHAEL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19700512","1020 BREMEN MOUNT ZION RD","WACO","GA","30182","1128b4","20241219","00000000","00000000",""
"CATALON","LEGARDA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19520414","2209 ORLANDO DR","SAN JOSE","CA","95122","1128b4","20241219","00000000","00000000",""
"CERVANTES","TRISHA","N","","BUS OWNER/EXEC","DME - GENERAL","","1134572936","19710516","P O BOX 2149","BRYAN","TX","77805","1128a1","20241219","00000000","00000000",""
"CHANG","PEILIN","","","PHYSICIAN (MD, DO)","ANESTHESIOLOGY","","1750421939","19680523","P O BOX 3379","FREEDOM","CA","95019","1128b4","20241219","00000000","00000000",""
"CLAMPITT","CONNIE","JO","","BUS OWNER/EXEC","LABORATORY","","0000000000","19710124","P O BOX 4000","ALICEVILLE","AL","35442","1128a3","20241219","00000000","00000000",""
"CLARK","MELISSA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810617","10200 E DRY CREEK ROAD, UNIT 3","ENGLEWOOD","CO","80112","1128b4","20241219","00000000","00000000",""
"CLAUDIO","ANGEL","LUIS","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1588604805","19561226","2701 N MCCOLL ROAD, TRAILER F5","MCALLEN","TX","78501","1128a1","20241219","00000000","00000000",""
"CLEMONS","TAHLOR","NICOLE","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19981226","3900 SPRING LANE","SAGINAW","MI","48603","1128b4","20241219","00000000","00000000",""
"CLOETERS","ADAM","JOSEPH","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810128","406 N TEMPLE ST","CORDELL","OK","73632","1128b4","20241219","00000000","00000000",""
"COLLINS","JIMMY","","","BUS OWNER/EXEC","CLINIC","","0000000000","19640517","P O BOX 150160","ATLANTA","GA","30315","1128a3","20241219","00000000","00000000",""
"COLLINS","JOSHUA","P","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830729","6 FIELDCREST AVE","WHEELING","WV","26003","1128b4","20241219","00000000","00000000",""
"COUSINS","DANIEL","DEAN SR","","IND- LIC HC SERV PRO","COUNSELOR","","1760782619","19760222","2647 7ST NE","MINNEAPOLIS","MN","55418","1128a4","20241219","00000000","00000000",""
"CRAVEN","CANDACE","MICHELE","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1114258746","19660327","5215 BESS MOORE ROAD","APISON","TN","37302","1128a3","20241219","00000000","00000000",""
"CREEL","KIMBERLY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19901009","85 CREEL RD","COLUMBIA","MS","39429","1128b4","20241219","00000000","00000000",""
"CRESPO","ALBERICO","AHIAS","","IND- LIC HC SERV PRO","COUNSELOR","","0000000000","19740917","2680 301 SOUTH","JESUP","GA","31599","1128b2","20241219","00000000","00000000",""
"CRITSER","GARY","MULFORD","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1154392892","19500626","1885 E ALLUVIAL, STE 101","FRESNO","CA","93702","1128b4","20241219","00000000","00000000",""
"DAVIDSON","JESSICA","LAUREN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840219","1402 COOK ST","KENNETT","MO","63857","1128b4","20241219","00000000","00000000",""
"DAVIES","ROSE","OMORIGIE","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","1730314642","19800101","P O BOX 27137","FORT WORTH","TX","76127","1128a1","20241219","00000000","00000000",""
"DAVIS","KIMBERLY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740125","5908 BROWNFIELDS DR","BATON ROUGE","LA","70811","1128a1","20241219","00000000","00000000",""
"DAVIS","MAURICE","","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19920406","1206 N KING STREET","WILMINGTON","DE","19801","1128a2","20241219","00000000","00000000",""
"DAVIS","RHONDA","G","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670721","2339 TIGERS TRAIL","DECATUR","IN","46733","1128a4","20241219","00000000","00000000",""
"DAVIS","SHAYNE","EARL MAURICE","","BUS OWNER/EXEC","COUNSELING CENTER","","1376054288","19981202","5658 SUNNINGDALE COURT","LAS VEGAS","NV","89122","1128a1","20241219","00000000","00000000",""
"DAVIS","TRENA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660201","59051 MARTIN LUTHER KING BLVD","PLAQUEMINE","LA","70764","1128a1","20241219","00000000","00000000",""
"DEFORD","TAMMY","SUE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730309","808 CENTER ST","UNION GROVE","WI","53182","1128b4","20241219","00000000","00000000",""
"DENNIS","VANCE","LAMAR","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19761219","222 OAK STREET","POTTSTOWN","PA","19464","1128a1","20241219","00000000","00000000",""
"DIBELER","LORELLE","CHRISTINA","","IND- LIC HC SERV PRO","THERAPIST","","1275931321","19870705","20603 BARKSTON CT","KATY","TX","77450","1128b4","20241219","00000000","00000000",""
"DOEKHIE","RAOUL","IMTIAAZM","","BUS OWNER/EXEC","MARKETING FIRM","","0000000000","19690330","P O BOX 779800","MIAMI","FL","33177","1128a3","20241219","00000000","00000000",""
"DOMINGUEZ","STACIE","LOUISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19641123","3430 W HANSEN","SHOW LOW","AZ","85901","1128b4","20241219","00000000","00000000",""
"DOSHI","TUSHAR","RAMNIK","","PHYSICIAN (MD, DO)","ORTHOPEDICS","","1093831133","19560719","27 DECENTE","IRVINE","CA","92614","1128a3","20241219","00000000","00000000",""
"DRESDNER","DANIEL","A","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1477947091","19880716","4032 NW 63RD STREET","COCONUT CREEK","FL","33073","1128a2","20241219","00000000","00000000",""
"DRISCOLL","JIMI","LEANN","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19681108","P O BOX 601","AFTON","OK","74331","1128b1","20241219","00000000","00000000",""
"DURON","ARTHUR","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19680618","9002 FROMAGE","SAN ANTONIO","TX","78250","1128b4","20241219","00000000","00000000",""
"EDOUARD","SONORE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790316","4 WINTERBERRY CT","MILLER PLACE","NY","11764","1128b4","20241219","00000000","00000000",""
"EHN","TIMOTHY","DENNIS","","IND- LIC HC SERV PRO","CHIROPRACTIC","","1306929047","19720609","P O BOX 6001","ASHLAND","KY","41105","1128a1","20241219","00000000","00000000",""
"ENCISO","CHELSEA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19990623","14644 RIO BRAVO RD","MORENO VALLEY","CA","92553","1128b4","20241219","00000000","00000000",""
"ENGLISH","JUSTIN","G II","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1942276431","19410907","44108 GREENVIEW DR","DAVIS","CA","95618","1128b4","20241219","00000000","00000000",""
"ENTSMINGER","LAURA","KAY","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19730104","4911 RICKER HILL ROAD","DAVENPORT","IA","52802","1128b1","20241219","00000000","00000000",""
"ESTOPEL","EDWIN","L","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19750325","155 LEE AVENUE","SAN FRANCISCO","CA","94112","1128a3","20241219","00000000","00000000",""
"EUBANKS","THOMAS","RICHARD","","PHYSICIAN (MD, DO)","SURGERY","","1730274168","19641127","1934 SE EAGLE AVENUE","GRESHAM","OR","97080","1128b4","20241219","00000000","00000000",""
"FIRESTONE","NICHOLAS","ALEXANDER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860812","2389 FAIRWAY DRIVE","YORK","PA","17408","1128a4","20241219","00000000","00000000",""
"FISHER","SCOTT","D","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19680417","817 SATURN AVENUE","IDAHO FALLS","ID","83402","1128a1","20241219","00000000","00000000",""
"FLORES","CHRISTOPHER","A","","BUS OWNER/EXEC","SUBCONTRACTOR (NON-H","","0000000000","19690528","2919 IVORY CREEK","SAN ANTONIO","TX","78258","1128a3","20241219","00000000","00000000",""
"FLORES","IRMA","E","","BUS OWNER/EXEC","SUBCONTRACTOR (NON-H","","0000000000","19490128","410 BENTLEY MANOR","SAN ANTONIO","TX","78249","1128a3","20241219","00000000","00000000",""
"FLORES","KENNETH","","","BUS OWNER/EXEC","SUBCONTRACTOR (NON-H","","0000000000","19730329","406 HAPPY TRAIL","SAN ANTONIO","TX","78231","1128a3","20241219","00000000","00000000",""
"FOFANA","ZENAB","","","EMPLOYEE - PRIVATE S","INTER CARE FACILITY","","0000000000","19880722","4900 CHIMNEY HILL CT","AUSTELL","GA","30106","1128a1","20241219","00000000","00000000",""
"FOUGHTY","MAGDA","SARAE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730810","344 PLACENTIA AVE","PISMO BEACH","CA","93449","1128b4","20241219","00000000","00000000",""
"FOX","RICHARD","ALAN","","IND- LIC HC SERV PRO","NURSE PRACTITIONER (","","1962474569","19560104","1386 50TH ST","SACRAMENTO","CA","95819","1128b4","20241219","00000000","00000000",""
"FRASER","CHRISTOPHER","DANIEL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920107","1569 GEORGE WASHINGTON ROAD","VOLANT","PA","16156","1128b4","20241219","00000000","00000000",""
"FREEMAN","ANGELA","LEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890628","21000 HIGHWAY 65","MILO","IA","50166","1128a3","20241219","00000000","00000000",""
"FREY","BRIAN","K","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19681114","840 WEIMER ROAD","BELLEFONTAINE","OH","43311","1128b4","20241219","00000000","00000000",""
"FULLER","HAZEL","L","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19681121","215 SHERIDAN STREET","JOLIET","IL","60436","1128a1","20241219","00000000","00000000",""
"GACIAS","DONNA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880207","1507 S MATTINA ST","TRACY","CA","95391","1128b4","20241219","00000000","00000000",""
"GANUZA","DANA","MARILYN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840412","2024 WALNUT ST","LA VERNE","CA","91750","1128b4","20241219","00000000","00000000",""
"GIBBS","GWENDOLYN","ARNETTA","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","1366574303","19510924","P O BOX 7007","MARIANNA","FL","32447","1128a1","20241219","00000000","00000000",""
"GODFREY","FLOYD","KEITH","","IND- LIC HC SERV PRO","COUNSELOR","","1518285741","19680827","3279 E FRUITVALE AVE","GILBERT","AZ","85297","1128b4","20241219","00000000","00000000",""
"GOEZ","GERALDINE","AREVALO","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19910727","3932 E KIMBERLY WAY","PHOENIX","AZ","85050","1128b1","20241219","00000000","00000000",""
"GOLDEN","ANDREW","","","IND- LIC HC SERV PRO","COUNSELOR","","1457835142","19680725","6122 AVALON DR E","NEW CANAAN","CT","06840","1128a1","20241219","00000000","00000000",""
"GOMEZ","GLORIA","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19661112","6060 MAIN ST NE, UNIT 301","MINNEAPOLIS","MN","55432","1128a1","20241219","00000000","00000000",""
"GOODSON","SARAH","SUNSHINE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19780727","1623 P STREET, APT 2","SACRAMENTO","CA","95814","1128b4","20241219","00000000","00000000",""
"GRAY","BRANDON","JIMMY BRANDON","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740529","13980 HIGHWAY 80","NEWTON","MS","39345","1128b4","20241219","00000000","00000000",""
"GRAY","DONNA","B","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","19610519","319 1ST ST, SE, APT A","MAGEE","MS","39111","1128a2","20241219","00000000","00000000",""
"GRAY","JANETTE","JOYCE","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1295721876","19630309","4719 CORONADO AVENUE","SAN DIEGO","CA","92107","1128b7","20241007","00000000","00000000",""
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