LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"","","","CONSERVATORY OF HOPE TREATMENT","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1124317086","","5755 S SANDHLL ROAD, #B","LAS VEGAS","NV","89120","1128b7","20241217","00000000","00000000",""
"","","","GOODNESS BEHAVIORAL HEALTH, LL","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1417463829","","6778 HONEYSUCKLE DRIVE","RENO","NV","89506","1128a1","20250120","00000000","00000000",""
"","","","INFINITE WELLNESS GROUP, LLC","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1770072076","","4520 SOUTH PECOS ROAD, SUITE 3","LAS VEGAS","NV","89121","1128a1","20250120","00000000","00000000",""
"","","","REMEDY WELLNESS AND RESOURCE C","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1164066601","","3650 N RANCHO DRIVE, SUITE 107","LAS VEGAS","NV","89130","1128a1","20250120","00000000","00000000",""
"","","","SILVER STATE COMMUNITY & HEALT","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1811426711","","6669 SMOKE RANCH ROAD","LAS VEGAS","NV","89108","1128a1","20250120","00000000","00000000",""
"","","","TRUE FAMILY SERVICES, INC","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1124308267","","914 EAST SAHARA AVENUE","LAS VEGAS","NV","89104","1128a1","20250120","00000000","00000000",""
"ABAD-SANTOS","CRISELDA","CALAYAN","","PHYSICIAN (MD, DO)","PSYCHIATRY","","1760461826","19631220","8506 N ADIR DR","WEST HILLS","CA","91304","1128b4","20250120","00000000","00000000",""
"ACOSTA","CARLOS","JORGE","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1598913345","19660311","580 PRAIRIE RIDGE DRIVE","WOODSTOCK","IL","60098","1128b4","20250120","00000000","00000000",""
"ADAMS","ARDALAAN","NEJAT","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19861130","P O BOX 5000","RANCHO SANTA FE","CA","92067","1128a1","20250120","00000000","00000000",""
"ADEOYE","VIVIEN","TEMITOPE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801128","153 PIXIE MOSS ROAD","POTTSTOWN","PA","19464","1128b4","20250120","00000000","00000000",""
"ADKINS","KAEDYN","","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","0000000000","20000906","2513 DEMING AVENUE","COLUMBUS","OH","43202","1128a1","20250120","00000000","00000000",""
"ALEXANDER","MEGGAN","JEAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19811019","1520 S DELAWARE AVENUE","MASON CITY","IA","50401","1128b1","20250120","00000000","00000000",""
"ALI","NASRA","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19891202","14300 34TH AVE N, APT 301","MINNEAPOLIS","MN","55447","1128a1","20250120","00000000","00000000",""
"ANDERSEN","CARLOS","EDUARDO","","PHYSICIAN (MD, DO)","SURGERY","","1477620128","19451009","96 CREST AVE 107","ALAMO","CA","94507","1128b4","20250120","00000000","00000000",""
"ANDERSON","LAUREN","CARMEN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940407","4462 LADYSMITH RD","RUTHER GLEN","VA","22546","1128b4","20250120","00000000","00000000",""
"ANUMBOR","JUSTINA","UZONWANNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19600426","1003 ASHLAND COURT","FORNEY","TX","75126","1128b4","20250120","00000000","00000000",""
"ARANDA","BRITANY","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19910628","12122 NS 3610","SEMINOLE","OK","74868","1128b4","20250120","00000000","00000000",""
"ASRES","NETSANET","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790103","5801 QUANTRELL AVE, APT 305","ALEXANDRIA","VA","22312","1128b4","20250120","00000000","00000000",""
"ATERS","MEGAN","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19831229","608 HELENA ST","CHARLESTON","MO","63834","1128a3","20250120","00000000","00000000",""
"ATZ-QUIHUIZ","NICOLE","SONYA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880328","3509 GISBORNE COURT","MODESTO","CA","95355","1128b4","20250120","00000000","00000000",""
"BALLARD","SUZANNA","DENISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890525","4631 STATE HIGHWAY F","WHITEWATER","MO","63785","1128b4","20250120","00000000","00000000",""
"BASS","CASSANDRA","LYN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19610706","11733 PAUL REVERE ROAD","DEMOTTE","IN","46310","1128b4","20250120","00000000","00000000",""
"BELL","PAMELA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19630801","1904 SE PICCADILLY ST","BLUE SPRINGS","MO","64014","1128b4","20250120","00000000","00000000",""
"BETTINGER","DAWN","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670516","16743 MAPLE AVENUE","CALDWELL","OH","43724","1128a3","20250120","00000000","00000000",""
"BLANKENSHIP","JENNIFER","BROOKE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19811012","6405 DUCK POND LANE","BAKERSFIELD","CA","93312","1128b4","20250120","00000000","00000000",""
"BLOSSER","JOHN","MARK","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19731104","1085 ATLANTIC BOULEVARD, APT 2","ATLANTIC BEACH","FL","32233","1128a1","20250120","00000000","00000000",""
"BODEPUDI","ARUDRA","","","PHYSICIAN (MD, DO)","NEUROLOGY","","1982782892","19590608","3883 CANYONLANDS ROAD, #13","STOCKTON","CA","95209","1128b4","20250120","00000000","00000000",""
"BOSS","MAURICE","EDWARD","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1912439084","19630607","30200 S OSWALT RD","COLTON","OR","97017","1128b4","20250120","00000000","00000000",""
"BOYCE","BRITTANY","ANTOINETTE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890506","801 S MAIN STREET, APT 3","GREER","SC","29650","1128a2","20250120","00000000","00000000",""
"BRABOY","KELLY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900811","412 PATINA PL SE","MABLETON","GA","30126","1128a1","20250120","00000000","00000000",""
"BRADLEY","SONYA","DENISE","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19650921","23 BRENT ST","SUMTER","SC","29150","1128b1","20250120","00000000","00000000",""
"BRADY","MARK","ROBERT","","IND- LIC HC SERV PRO","EMERGENCY MED TECH","","0000000000","19680621","24533 RIDGEWOOD DRIVE","MURRIETA","CA","92562","1128b4","20250120","00000000","00000000",""
"BRAYLOVSKY","ANATOLY","","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1023004124","19710527","P O BOX 10","LISBON","OH","44432","1128a1","20250120","00000000","00000000",""
"BRIDGES","BRITNEY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19881231","539 E PHILADELPHIA AVENUE","YOUNGSTOWN","OH","44502","1128a3","20250120","00000000","00000000",""
"BROAD","WILLIAM","GOWING","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1750374591","19570807","15949 ORANGE BLOSSOM LANE","LOS GATOS","CA","95032","1128b4","20250120","00000000","00000000",""
"BUCKNER","MARK","BRIAN","","PHYSICIAN (MD, DO)","EMERGENCY MEDICINE","","1396752879","19601001","332 KLAS ROAD","SHERMAN","TX","75092","1128b4","20250120","00000000","00000000",""
"BUESING","SAMANTHA","ANNE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860605","4320 MINKLER ROAD","YORKVILLE","IL","60560","1128b4","20250120","00000000","00000000",""
"BUFFUM","LISA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1205145802","19821207","109 LANCE COURT","MARTINEZ","CA","94553","1128b4","20250120","00000000","00000000",""
"BUNTON-DODSON","ASHLEY","","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","1114313954","19870903","719 OAKBRIDGE COURT","NORTH LAS VEGAS","NV","89032","1128a1","20250120","00000000","00000000",""
"BURNS","CASSANDRA","","","INDIVIDUAL (UNAFFILI","NO KNOWN AFFILIATION","","0000000000","19820101","222 JACKSON ST","ARLINGTON","TN","38002","1128a1","20250120","00000000","00000000",""
"BURRIS","BENJAMIN","GRAY","","IND- LIC HC SERV PRO","DENTIST","","1942302294","19711110","12540 PARK AVE","WINDERMERE","FL","34786","1128b4","20250120","00000000","00000000",""
"BURROUGHS","RENEE","HEARD","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19580122","333 E PIRU ST 1","LOS ANGELES","CA","90061","1128b4","20250120","00000000","00000000",""
"BURRUSS","CHARLES","A","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19690210","P O BOX 3949","PENSACOLA","FL","32516","1128a1","20250120","00000000","00000000",""
"CAIN","KELEY","ALEXANDRA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920729","631 ASH WAY","BUENA PARK","CA","90621","1128b4","20250120","00000000","00000000",""
"CALLARD","NATALIA","FRANCISCO","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820109","3520 NW 20TH STREET","OKLAHOMA CITY","OK","73107","1128b4","20250120","00000000","00000000",""
"CAMIRAND","JEFFERY","E","","IND- LIC HC SERV PRO","TECHNICIAN","","0000000000","19910627","11900 KETTERING DR","BAKERSFIELD","CA","93312","1128b4","20250120","00000000","00000000",""
"CAMPBELL","PATRICK","","","IND- LIC HC SERV PRO","EMERGENCY MED TECH","","0000000000","19690716","9210 HORSESHOE BAR ROAD","LOOMIS","CA","95650","1128b4","20250120","00000000","00000000",""
"CARTER","KEYANA","","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","1508380247","19920425","4148 E HALE CIRCLE","MESA","AZ","85205","1128a1","20250120","00000000","00000000",""
"CATO-STRONG","GAIL","RENEE","","IND- LIC HC SERV PRO","COUNSELOR","","1477997195","19860717","3310 N 23RD WEST AVENUE","TULSA","OK","74127","1128a1","20250120","00000000","00000000",""
"CERVANTES-SANCHEZ","DULCE","CAROLINA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800701","25392 W CARSON DR","BUCKEYE","AZ","85326","1128b4","20250120","00000000","00000000",""
"CHACON","CARLOS","ORLANDO","","PHYSICIAN (MD, DO)","PLASTIC SURGERY","","1790126316","19741113","480 ALTA ROAD","SAN DIEGO","CA","92179","1128a2","20250120","00000000","00000000",""
"CHADEAYNE","DIANE","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1558555672","19500511","10801 S INTERSTATE 35, APT 145","AUSTIN","TX","78747","1128b4","20250120","00000000","00000000",""
"CHATAT","HAMDEH","MOHAMMED","","EMPLOYEE - PRIVATE S","CONSULTING FIRM","","0000000000","19811031","9529 PRAIRIE AVENUE, APT 18","HIGHLAND","IN","46322","1128a1","20250120","00000000","00000000",""
"CHAVEZ","MARK","","","PHYSICIAN (MD, DO)","EMERGENCY MEDICINE","","1487813150","19700629","6526 AVENIDA MANANA","LA JOLLA","CA","92037","1128b4","20250120","00000000","00000000",""
"CHAVEZ","STEPHANIE","ALEXA","","EMPLOYEE - PRIVATE S","HOSPICE","","0000000000","19950417","1607 OVERSHINE LANE","MIDLAND","TX","79705","1128a1","20250120","00000000","00000000",""
"CHAVEZ","ZENIA","FUENTES","","BUS OWNER/EXEC","HOME HEALTH AGENCY","","0000000000","19751002","37910 N 45TH AVENUE","PHOENIX","AZ","85086","1128a1","20250120","00000000","00000000",""
"CHIN","QUEE","FAH","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1588691786","19610817","8000 DEL REY AVENUE","LAS VEGAS","NV","89117","1128b4","20250120","00000000","00000000",""
"CITIZEN","TIFFANY","RENEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840614","4617 JURUPA AVENUE, APT 10","RIVERSIDE","CA","92506","1128b4","20250120","00000000","00000000",""
"CLANTON","SAMUEL","THOMAS","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1992148100","19780324","1226 NW 23RD TER","GAINESVILLE","FL","32605","1128b4","20250120","00000000","00000000",""
"COBB","JASMINE","STARR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19871002","1700 SW LONGVIEW RD","LEES SUMMIT","MO","64081","1128b4","20250120","00000000","00000000",""
"COCKERELL","QUINTAN","","","EMPLOYEE - PRIVATE S","MARKETING FIRM","","0000000000","19810521","P O BOX 1000","DULUTH","MN","55814","1128a1","20250120","00000000","00000000",""
"COOPER","SCOTT","","","PHYSICIAN (MD, DO)","INTERNAL MEDICINE","","1215917760","19620405","P O BOX 1000","OTISVILLE","NY","10963","1128a4","20250120","00000000","00000000",""
"COSIO","IXCHEL","MARISE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19741127","15508 WOODCREST DRIVE","WHITTIER","CA","90604","1128b4","20250120","00000000","00000000",""
"COULY","ALEA","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19811020","318 FALLOW CIRCLE","CLARKSVILLE","TN","37040","1128b4","20250120","00000000","00000000",""
"COX","INDYA","ASYALEE","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","0000000000","20001217","4545 ENGRAM DR, APT 6314","GULFPORT","MS","39501","1128a2","20250120","00000000","00000000",""
"COX","JOSEPH","CLARENCE","","IND- LIC HC SERV PRO","DENTIST","","1669580437","19790815","P O BOX 5107","UNION SPRINGS","AL","36089","1128b4","20250120","00000000","00000000",""
"COX RIDDLE","ANGIE","RENEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1962745356","19660508","418 WIND DANCE DR","LEBANON","TN","37087","1128b4","20250120","00000000","00000000",""
"CRNARICH","MEAGAN","NICOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860217","3918 SHELBY ROAD","YOUNGSTOWN","OH","44511","1128a2","20250120","00000000","00000000",""
"CROSS","KATE","KATHLEEN LA RAI","","IND- LIC HC SERV PRO","COUNSELOR","","1417230582","19620528","526 S 3RD STREET","COUNCIL BLUFFS","IA","51503","1128a1","20250120","00000000","00000000",""
"CRUZ","JUDY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19640304","1940 YUCCA DR","EL CENTRO","CA","92243","1128b4","20250120","00000000","00000000",""
"CUFF","SHAWNA","VIRGINIA","","BUS OWNER/EXEC","ADULT HOME","","0000000000","19820605","4370 SMILEY ROAD","LAS VEGAS","NV","89115","1128a2","20250120","00000000","00000000",""
"DALLAS","CANEISHA","RESHAY","","EMPLOYEE - PRIVATE S","DENTAL PRACTICE","","0000000000","19911211","15039 ARIZONA SKY CT","HUMBLE","TX","77396","1128a1","20250120","00000000","00000000",""
"DANSBY","PRINCESS","E","","EMPLOYEE - ST/LOC/TR","STATE GOV'T","","0000000000","19820217","P O BOX 54","PRESCOTT","AR","71857","1128a2","20250120","00000000","00000000",""
"DAVIS","ALICIA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790908","5624 N 69TH AVENUE","OMAHA","NE","68104","1128b4","20250120","00000000","00000000",""
"DEL ROSARIO-GONZALEZ","NANCY","","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1801828611","19400923","1906 BORDEAUX CT","ALLEN","TX","75002","1128b4","20250120","00000000","00000000",""
"DELEON","KENNIETH","BRIAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19871127","502 YOKON BLVD","SAN ANTONIO","TX","78221","1128b4","20250120","00000000","00000000",""
"DODDS","PHYLLIS","ADELE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19490427","10115 WRIGHT AVE","KLAMATH FALLS","OR","97603","1128a2","20250120","00000000","00000000",""
"DOTY","TAKEYLA","KANTRICE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820808","P O BOX 88550","PEARL","MS","39208","1128a4","20250120","00000000","00000000",""
"DRUM","DAWN","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19680811","4008 RUGER AVE","JANESVILLE","WI","53546","1128a4","20250120","00000000","00000000",""
"DUBARD","COURTNEY","ROGILLIO ELIZAB","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880110","114 CHOCTAW BEND","CLINTON","MS","39056","1128b4","20250120","00000000","00000000",""
"DUNN","NIKKOLE","ROBYN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1346868148","19760224","8559 N JOHN ALBERT AVE","FRESNO","CA","93720","1128b4","20250120","00000000","00000000",""
"DURKIN","JOHN","BENJAMIN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1164032249","19770322","3604 S ARROYO LN","GILBERT","AZ","85297","1128b4","20250120","00000000","00000000",""
"EAGLE HAWK","LIONEL","LEE","","EMPLOYEE - PRIVATE S","ADULT HOME","","0000000000","19851120","1412 WOOD ST","SPRINGFIELD","SD","57062","1128a2","20250120","00000000","00000000",""
"ECHEBIRI","IJEOMA","KELECHI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19730221","18027 OAKRIDGE CANYON LANE","RICHMOND","TX","77407","1128b4","20250120","00000000","00000000",""
"EDWARDS","MICHAEL","CHARLES","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1891774147","19671025","1307 1 BROOKHURST STREET, STE","GARDEN GROVE","CA","92843","1128a3","20250120","00000000","00000000",""
"EK","SOKHOMMUNY","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19790101","10401 SE 186TH PLACE","RENTON","WA","98055","1128a1","20250120","00000000","00000000",""
"ENDRES","BRITTANY","MICHELLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900407","906 N ANNA STREET","WICHITA","KS","67212","1128a2","20250120","00000000","00000000",""
"FALLS","FELICIA","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19760129","10756 S WENTWORTH AVENUE, APT","CHICAGO","IL","60628","1128a1","20250120","00000000","00000000",""
"FASIG","ANGELA","BABETTE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19630907","2222 CYPRESS COVE DR, G7","TAVARES","FL","32778","1128b4","20250120","00000000","00000000",""
"FAULKS","LONNY","J","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1831911080","19691009","4220 8TH ST SW LOT C138","DEMING","NM","88030","1128b4","20250120","00000000","00000000",""
"FELD","HEATHER","RENEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19851007","5244 S 25TH ST","MILWAUKEE","WI","53221","1128b4","20250120","00000000","00000000",""
"FERGUSON","KENNETH","KRISTOPHER","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920805","365 MILDRED ROAD","GILMER","TX","75644","1128a2","20250120","00000000","00000000",""
"FLETCHER","ORLANDES","III","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19740719","3927 W 109TH ST","INGLEWOOD","CA","90303","1128b4","20250120","00000000","00000000",""
"FOX","ALYSSA","ROSE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19991001","12902 E HIGHWAY 20","CLEARLAKE OAKS","CA","95423","1128a1","20250120","00000000","00000000",""
"FRANKS","SHANELLE","LYNAE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860611","12699 ALVEDA ST","VICTORVILLE","CA","92394","1128b4","20250120","00000000","00000000",""
"FREEMAN","ANDI","KAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19720419","25406 CHINA SPRINGS","SPRING","TX","77373","1128b4","20250120","00000000","00000000",""
"FREEMAN","RUSSELL","","","BUS OWNER/EXEC","COMM MNTL HLTH CNTR","","0000000000","19700526","6510 S HAZELTON LANE, UNIT 103","TEMPE","AZ","85283","1128a1","20250120","00000000","00000000",""
"FRIMPONG","VIVIAN","SERWAA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19660604","7319 SERENOA DRIVE","REYNOLDSBURG","OH","43068","1128a1","20250120","00000000","00000000",""
"FURUKAWA","MATTHEW","YOSHIO","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19571221","623 DELTA WAY","WATSONVILLE","CA","95076","1128b4","20250120","00000000","00000000",""
"GALBRAITH","AMBER","CECILE","","IND- LIC HC SERV PRO","COUNSELOR","","1174828586","19691104","1545 VILLA RICA DRIVE","HENDERSON","NV","89052","1128b7","20241217","00000000","00000000",""
"GALLEGOS","JENNIFER","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19781204","321 S GUNNISON STREET","BURLINGTON","IA","52601","1128a4","20250120","00000000","00000000",""
"GARLAND","ASHLEY","NICOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19900125","223 STATE ROUTE 188","TRENTON","TN","38382","1128b4","20250120","00000000","00000000",""
"GASCON","CHRISTINE","MICHELLE","","IND- LIC HC SERV PRO","COUNSELOR","","1508211103","19790216","P O BOX 721","CHOTEAU","MT","59422","1128a1","20250120","00000000","00000000",""
"GEORGESCU","NATALIA","","","BUS OWNER/EXEC","DME - ORTHOTICS","","0000000000","19830101","36 MINNETONKA RD","SEA RANCH LAKES","FL","33308","1128a1","20250120","00000000","00000000",""
"GEORGESCU","TACHE","GABE","","BUS OWNER/EXEC","DME - ORTHOTICS","","0000000000","19770417","27884 VIA MAGDALENA","LAGUNA NIGUEL","CA","92677","1128a1","20250120","00000000","00000000",""
"GRADOWSKA","ALAN","KRISTIAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19931008","12223 N 21ST AVE, APT 4","PHOENIX","AZ","85029","1128b4","20250120","00000000","00000000",""
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