LASTNAME,FIRSTNAME,MIDNAME,BUSNAME,GENERAL,SPECIALTY,UPIN,NPI,DOB,ADDRESS,CITY,STATE,ZIP,EXCLTYPE,EXCLDATE,REINDATE,WAIVERDATE,WVRSTATE
"","","","DISCOVERY DIAGNOSTIC LABORATOR","OTHER BUSINESS","LAB - CLINICAL","","1669733697","","C/O EMMA & ARNACK KHACHATRYAN","WALTHAM","MA","02452","1128a1","20250820","00000000","00000000",""
"","","","QUIVVY TECH CORPORATION","DME COMPANY","DME - GENERAL","","0000000000","","1489 W PALMETTO PARK ROAD, STE","BOCA RATON","FL","33486","1128b7","20250516","00000000","00000000",""
"","","","RELIABLE DOCUMENT SOLUTIONS, L","DME COMPANY","DME - GENERAL","","1306227269","","902 CLINT MOORE ROAD, SUITE 11","BOCA RATON","FL","33487","1128b7","20250516","00000000","00000000",""
"","","","SATORI RECOVERY CENTER, LLC","OTHER BUSINESS","SUBSTANCE ABUSE REHA","","1831545078","","2260 PARK AVENUE","LAGUNA BEACH","CA","92651","1128a1","20250820","00000000","00000000",""
"","","","SQUARE ONE BEHAVIORAL HEALTH,","OTHER BUSINESS","MENTAL/BEHAVIORAL HE","","1609351725","","2923 W CHARLESTON BLVD","LAS VEGAS","NV","89102","1128a1","20250820","00000000","00000000",""
"ABDALLAH","HASSAN","SUBHI","","IND- LIC HC SERV PRO","PHARMACIST","","1669594099","19710513","36379 LITTLE MACK AVE","CLINTON TOWNSHIP","MI","48035","1128a1","20250820","00000000","00000000",""
"ABDELRAZZAQ","ALI","","","IND- LIC HC SERV PRO","PHARMACIST","","0000000000","19760324","36378 DOMINION CIR #56","STERLING HEIGHTS","MI","48310","1128a1","20250820","00000000","00000000",""
"ALI","MOHAMMED","KAZIM","","BUS OWNER/EXEC","LABORATORY-IDTF","","1790849370","19510918","MAXWELL AIR FORCE BASE","MONTGOMERY","AL","36112","1128a1","20250820","00000000","00000000",""
"ALLEN-BRADY","RYAN","WILLIAM","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1134691173","19830701","535 W CAMBRIDGE AVENUE","PHOENIX","AZ","85003","1128b4","20250820","00000000","00000000",""
"ALTEPETER","MICHELE","RAE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19710510","3900 N STATE HIGHWAY 7","NORTH VERNON","IN","47265","1128a4","20250820","00000000","00000000",""
"ANDERSON","ORETHA","NAPPY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19691129","314 MASSEY BRANCH RD","CLAYTON","DE","19938","1128b4","20250820","00000000","00000000",""
"AREVALO","TANYA","","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19870101","6514 ELMWOOD AVENUE","CINCINNATI","OH","45216","1128a3","20250820","00000000","00000000",""
"ASIEGBUNAM","EJIKE","CHIJIOKE","","BUS OWNER/EXEC","UNIVERSITY/COLLEGE","","0000000000","19680916","P O BOX 1000","WHITE DEER","PA","17887","1128a3","20250820","00000000","00000000",""
"AYODEJI","SHERIFAT","OLUBUNMI","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800818","11602 CLASSMORE GAP","SAN ANTONIO","TX","78245","1128b4","20250820","00000000","00000000",""
"BAETA","CARMEN","CAROL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19561018","28 PASEO PRIETO","FREEDOM","CA","95019","1128a3","20250820","00000000","00000000",""
"BARACEWICZ","JOHN","JACOB","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19631008","4 LINDALL STREET","DANVERS","MA","01923","1128a1","20250820","00000000","00000000",""
"BARQUET","ARIELLE","JARDE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19880120","220 NEIL AVENUE","NEW ORLEANS","LA","70131","1128b4","20250820","00000000","00000000",""
"BASILE","ANTHONY","JOSEPH","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19700402","P O BOX 3000","WHITE DEER","PA","17887","1128a1","20250820","00000000","00000000",""
"BELEW","GREGORY","SIMON","","IND- LIC HC SERV PRO","COUNSELOR","","1649822743","19831123","1007 E TRON AVE","SALINA","KS","67401","1128b4","20250820","00000000","00000000",""
"BENTLEY","TANEDA","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860327","1121 SUMMIT ST","COLUMBUS","OH","43201","1128a2","20250820","00000000","00000000",""
"BETTRIDGE","KELLY","J","","IND- LIC HC SERV PRO","TECHNICIAN","","0000000000","19611117","23 CARA VELLA LN","CENTERVILLE","UT","84014","1128b4","20250820","00000000","00000000",""
"BLANKSON","TANDRA","NECOLE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800807","2183 S ENSENADA ST","AURORA","CO","80013","1128b4","20250820","00000000","00000000",""
"BLUNIER","JOSEF","ANDREW","","IND- LIC HC SERV PRO","PHARMACIST","","1447592217","19770831","455 S GORDON STREET","NAUVOO","IL","62354","1128a4","20250820","00000000","00000000",""
"BOWLES","DESHA","R","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19730918","335 GARRETT ST","SACRAMENTO","KY","42372","1128a1","20250820","00000000","00000000",""
"BOWLES","TONYA","R","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19661021","730 E SEVIER AVE","KINGSPORT","TN","37660","1128b4","20250820","00000000","00000000",""
"BRENNER","RUTH","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19600526","7446 SANDY SPRINGS PT","FOUNTAIN","CO","80817","1128b4","20250820","00000000","00000000",""
"BRICE","JOE","CHRISTOPHER","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","1760929400","19601225","3901 KLEIN BLVD","ADELANTO","CA","92301","1128a1","20250820","00000000","00000000",""
"BRUNO","HEATHER","ANN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840514","2004 PULLEY PL","NOLENSVILLE","TN","37135","1128b4","20250820","00000000","00000000",""
"BURNS","MAXINE","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19790126","116 PINE GROVE RD","WILLOW SPRINGS","MO","65793","1128b4","20250820","00000000","00000000",""
"CADET","MA GRACIA","DEPANO","","BUS OWNER/EXEC","DME - GENERAL","","1194441782","19701012","3035 MANDOLIN DR","KISSIMMEE","FL","34744","1128a1","20250820","00000000","00000000",""
"CAIN","LEONARD","ALONZO","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19690612","339 W EAGLE LAKE DR","MAPLE GROVE","MN","55369","1128a1","20250820","00000000","00000000",""
"CALDERA","MIGUEL","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840601","13163 FOUNTAIN PARK DR, APT B2","PLAYA VISTA","CA","90094","1128b4","20250820","00000000","00000000",""
"CALLAHAN","LESLIE","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19850410","721 CHAMBERSBURG ROAD, APT O","GETTYSBURG","PA","17325","1128b4","20250820","00000000","00000000",""
"CANOVA CEBRIAN","JAKELINE","ACNET","","BUS OWNER/EXEC","CHECK CASHING STORE","","0000000000","19660316","P O BOX 1731","WASECA","MN","56093","1128a1","20250820","00000000","00000000",""
"CARMONA BARRIOS","ERICK","","","IND- LIC HC SERV PRO","THERAPIST","","1932747250","19720831","2802 SW 142ND COURT","MIAMI","FL","33175","1128b4","20250820","00000000","00000000",""
"CARPENTER","ASHLEY","R","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","1346983780","19850725","1318 E 93RD ST","CLEVELAND","OH","44106","1128a1","20250820","00000000","00000000",""
"CHEATHAM","ENDIA","E","","IND- LIC HC SERV PRO","HEALTH CARE AIDE","","1831614551","19770227","P O BOX 4525","AKRON","OH","44310","1128a1","20250820","00000000","00000000",""
"CHRISTMAS","HANNAH","DANIELLE","","IND- LIC HC SERV PRO","PHYSICAL THERAPY","","1265821292","19900912","140 ASHLEY ROAD 441","HAMBURG","AR","71646","1128a1","20250820","00000000","00000000",""
"CONWAY","SHANNON","RENEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19700204","3921 BRECK LN","SARASOTA","FL","34232","1128b4","20250820","00000000","00000000",""
"COOK","HALEIGH","LANE","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","1083235568","19960207","746 N NELSON ROAD, APT B","COLUMBUS","OH","43219","1128a1","20250820","00000000","00000000",""
"COOLEY","RACHEL","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890226","2305 DALE HALL ROAD","MILTON","FL","32570","1128b4","20250820","00000000","00000000",""
"COOMES","JODI","MICHELLE","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","0000000000","19971216","216 PINEVIEW DR","MOORESVILLE","IN","46158","1128b1","20250820","00000000","00000000",""
"CORBITT","JANAY","","","BUS OWNER/EXEC","COUNSELING CENTER","","1205217023","19881004","884 COITSVILLE-HUBBARD ROAD","YOUNGSTOWN","OH","44505","1128a1","20250820","00000000","00000000",""
"CORDERO","RIGOBERTO","","","BUS OWNER/EXEC","MENTAL/BEHAVIORAL HE","","1326577511","19631202","P O BOX 01920","MIAMI","FL","33101","1128a1","20250820","00000000","00000000",""
"CROMWELL","LATOYA","SYMONE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19920909","303 WOODLAND DR","LOUISA","VA","23093","1128a1","20250820","00000000","00000000",""
"CURFMAN","KENNETH","SCOTT","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19810710","P O BOX 102","NORWOOD","CO","81423","1128b4","20250820","00000000","00000000",""
"CURRAN","CHRISTOPHER","S","","IND- LIC HC SERV PRO","THERAPIST","","0000000000","19710214","480 S JOANNE AVENUE","VENTURA","CA","93003","1128b4","20250820","00000000","00000000",""
"DANIELS","TAMMY","LEE","","EMPLOYEE - PRIVATE S","PHYSICIAN PRACTICE (","","0000000000","19690327","P O BOX 27137","FORT WORTH","TX","76127","1128a1","20250820","00000000","00000000",""
"DAVIS","MARLENA","S","","EMPLOYEE - ST/LOC/TR","STATE GOV'T","","0000000000","19860510","2527 W CONGRESS PARKWAY, UNIT","CHICAGO","IL","60612","1128a1","20250820","00000000","00000000",""
"DAVIS","RICHARD","","","IND- LIC HC SERV PRO","COUNSELOR","","1457719098","19700818","P O BOX 14500","LEXINGTON","KY","40512","1128a1","20250820","00000000","00000000",""
"DELVA","JOSEDANIE","PIERRE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19820611","182 EARNEST WAY","KENLY","NC","27542","1128b4","20250820","00000000","00000000",""
"DINGLE","DANIEL","","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19700622","P O BOX 14500","LEXINGTON","KY","40512","1128a3","20250820","00000000","00000000",""
"DOUD","ASHLEY","LYNN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19871029","3068 VILLAGE DR","EDGEWOOD","KY","41017","1128b4","20250820","00000000","00000000",""
"DOUGLAS","ASHLEY","ISHELL","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19940528","9950 W INDIAN SCHOOL ROAD, UNI","PHOENIX","AZ","85037","1128b4","20250820","00000000","00000000",""
"DUNCAN","THOMAS","E","","EMPLOYEE - FEDERAL -","EMPLOYEE - GRADE UNK","","0000000000","19830523","P O BOX 1000","MARION","IL","62959","1128a3","20250820","00000000","00000000",""
"EHRET","NATHAN","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19851105","6065 LAVENHAM RD SW","MASSILLON","OH","44646","1128a3","20250820","00000000","00000000",""
"EVANS","AHMAD","D","","EMPLOYEE - PRIVATE S","MENTAL/BEHAVIORAL HE","","1184004582","19820310","204 BEECH ST","COVINGTON","LA","70433","1128a1","20250820","00000000","00000000",""
"FERDINAND","NICOLE","M","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19790913","3214 KIRKLIN ST","PAULINA","LA","70763","1128a1","20250820","00000000","00000000",""
"FISHER","JAMES","ANTHONY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19601111","10800 EMMA JEAN WAY","LOUISVILLE","KY","40272","1128b4","20250820","00000000","00000000",""
"FITZGERALD","SHANNYCE","","","EMPLOYEE - PRIVATE S","PERSONAL CARE PROVID","","0000000000","19770109","6351 ZANE AVE N, APT 304","MINNEAPOLIS","MN","55429","1128a1","20250820","00000000","00000000",""
"FORD","CHRISTOPHER","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19830828","5495 ESPLANADE ST","COLUMBUS","OH","43221","1128a1","20250820","00000000","00000000",""
"FORMAN","JACQUELINE","N","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19800111","5153 AKRON ST","PHILADELPHIA","PA","19124","1128a1","20250820","00000000","00000000",""
"FRANCIS","TIFFANY","L","","EMPLOYEE - PRIVATE S","HOSPITAL","","0000000000","19760120","5120 MAGELLAN WAY","FRANKLIN","OH","45005","1128a3","20250820","00000000","00000000",""
"FRANK","ALEXANDER","FREDERICK","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1164450573","19700122","5500 PERSHING CIRCLE","EDMOND","OK","73034","1128a2","20250820","00000000","00000000",""
"FREA","ANNE","MARIE","","PHYSICIAN (MD, DO)","GENERAL PRACTICE","","1952593725","19800321","617 DOWNING DRIVE","WAUKESHA","WI","53186","1128a1","20250820","00000000","00000000",""
"FRYE","STEPHANIE","MORGAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1154845022","19611002","3101 MILLERTON WAY","THOMPSONS STATION","TN","37179","1128b4","20250820","00000000","00000000",""
"FULWEILER","KELSEY","CHRISTINE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19960720","3185 KARTH RD, APT 109","SAINT PAUL","MN","55110","1128b4","20250820","00000000","00000000",""
"FUSCH","GRAHAM","ARTHUR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19840806","7515 WINNETKA AVENUE, APT 303","WINNETKA","CA","91306","1128b4","20250820","00000000","00000000",""
"GAFFNEY","TESSA","MARIE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19801112","4330 SPECTUM ONE, APT 5309","SAN ANTONIO","TX","78230","1128b4","20250820","00000000","00000000",""
"GARBARINO","GIACOMO","LORENZO","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19590418","1227 TEMPLE CITY BLVD, UNIT 6","ARCADIA","CA","91007","1128a1","20250820","00000000","00000000",""
"GAUTHIER","LISA","MARIE","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1164027074","19790709","38 HARDING ST","ROCHESTER","NH","03867","1128b4","20250820","00000000","00000000",""
"GAYLE","FRANCENE","ARETHA","","PHYSICIAN (MD, DO)","FAMILY PRACTICE","","1922080415","19740128","P O BOX 7006","MARIANNA","FL","32447","1128a1","20250820","00000000","00000000",""
"GHUSSIN","KINDY","","","IND- LIC HC SERV PRO","PHARMACIST","","1992904031","19740609","P O BOX 33","TERRE HAUTE","IN","47808","1128a1","20250820","00000000","00000000",""
"GOMES","ANDREW","EKANSH","","PHYSICIAN (MD, DO)","RADIOLOGY","","1215068796","19760703","2105 CONSTRUCTN AVE","SAN JUAN","PR","00901","BRCH SA","20250710","00000000","00000000",""
"GOMEZ RIVAS","ASTRID","CAROLINA","","BUS OWNER/EXEC","CHECK CASHING STORE","","0000000000","19650224","1130 NW 79TH DR","FORT LAUDERDALE","FL","33322","1128a1","20250820","00000000","00000000",""
"GONEAU","KRISTA","KAY","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1093900516","19770524","8416 NE BOONE ST APT 107","KANSAS CITY","MO","64155","1128b4","20250820","00000000","00000000",""
"GONZALEZ","GUADALUPE","","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19740619","2063 SAINT JOHNS ROAD","DALE","TX","78616","1128a1","20250820","00000000","00000000",""
"GOWAN","HEATHER","STARR","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19780102","208 N GEORGIA AVE, APT A6","CHESNEE","SC","29323","1128a2","20250820","00000000","00000000",""
"GRANADOS","VIRNA","","","EMPLOYEE - PRIVATE S","ASSISTED LIVING FACI","","1750914099","19671114","9310 VEDRA POINTE LN","BOCA RATON","FL","33496","1128a1","20250820","00000000","00000000",""
"GREEN","AMY","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19831124","328 E 300 N","CENTERVILLE","UT","84014","1128b4","20250820","00000000","00000000",""
"GREEN","MARQUES","ELIJAH","","BUS OWNER/EXEC","DME - GENERAL","","0000000000","19950325","P O BOX 1031","COLEMAN","FL","33521","1128a1","20250820","00000000","00000000",""
"HALL","ABIGAIL","JOYCE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19721228","GLEN RAY ROAD, BOX A","ALDERSON","WV","24910","1128a2","20250820","00000000","00000000",""
"HALL","MORGAN","","","IND- LIC HC SERV PRO","TECHNICIAN","","0000000000","19951024","325 E WINCHESTER ST","GALLATIN","TN","37066","1128b4","20250820","00000000","00000000",""
"HAYES","PROCTOR","NORMAN","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670520","2525 NAPIER AVE","MACON","GA","31204","1128b4","20250820","00000000","00000000",""
"HECHT","AMY","ANN","","IND- LIC HC SERV PRO","COUNSELOR","","1235532433","19840810","2525 W 22ND STREET","SIOUX CITY","IA","51103","1128a1","20250820","00000000","00000000",""
"HERBERT","DANEEN","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19610818","306 HUNTERS PATH","YORK","PA","17402","1128b4","20250820","00000000","00000000",""
"HERNANDEZ","KATHY","M","","IND- LIC HC SERV PRO","PHARMACY TECHNICIAN","","0000000000","19850330","P O BOX 4000","ALICEVILLE","AL","35442","1128a4","20250820","00000000","00000000",""
"HERNANDEZ DEL SOL","NIURBIS","","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","1710433966","19900918","2553 W 76TH ST, APT 103","HIALEAH","FL","33016","1128b4","20250820","00000000","00000000",""
"HILL","DRAKE","T","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","20020128","311 VENNUM AVENUE","MANSFIELD","OH","44903","1128a3","20250820","00000000","00000000",""
"HOBBS","TYJEE","BARRETT","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","1699239335","19940708","1540 CASTLE HILL DRIVE, UNIT 2","COLUMBUS","OH","43219","1128a1","20250820","00000000","00000000",""
"HOFFMEISTER","JERRY","LEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19710814","14223  KOHNKE HILL ROAD","HAMMOND","LA","70401","1128b4","20250820","00000000","00000000",""
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"HOLT","SAMUEL","TRENT","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19830104","4920 S LAKE PINES DR, APT 2A","SALT LAKE CITY","UT","84107","1128b4","20250820","00000000","00000000",""
"HOY-DINGMANN","LYNNETTE","RENE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670323","4500 SINGING PINES LANE","PLACERVILLE","CA","95667","1128b4","20250820","00000000","00000000",""
"HUFFMAN","LAWANIA","PENICK","","EMPLOYEE - PRIVATE S","HOME HEALTH AGENCY","","0000000000","19740327","1599 CASCADE MILL ROAD","CASCADE","VA","24069","1128a1","20250820","00000000","00000000",""
"HUNTER","SHEVONDA","TERESE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19780912","410 N ROOSEVELT DR, UNIT A","MINDEN","LA","71055","1128b4","20250820","00000000","00000000",""
"HYDAR","SALLY","M","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19680829","614 PERUQUE DR","O FALLON","MO","63366","1128a1","20250820","00000000","00000000",""
"HYDE","MARK","ANTHONY","","INDIVIDUAL (UNAFFILI","PERSONAL CARE PROVID","","0000000000","19620815","1051 W 42ND PL, APT 110","LOS ANGELES","CA","90037","1128a1","20250820","00000000","00000000",""
"HYLAND","MANDY","ERIN","","IND- LIC HC SERV PRO","SOCIAL WORKER","","1346513082","19800703","1010 WEST SIXTH AVENUE","SHAKOPEE","MN","55379","1128a2","20250820","00000000","00000000",""
"IHEZIE","CHIOMA","CELESTINA","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19860930","181 AUTUMN ST","MANCHESTER","CT","06040","1128b4","20250820","00000000","00000000",""
"JACKSON","ELIZABETH","RENEE","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19890713","22 CYPRESS MEADOW LOOP","SLIDELL","LA","70460","1128b4","20250820","00000000","00000000",""
"JACKSON","WESLEY","R","","BUS OWNER/EXEC","MANAGEMENT SVCS CO","","0000000000","19960128","1 SAINT MARKS PLACE","DIX HILLS","NY","11746","1128a1","20250820","00000000","00000000",""
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"JOHNSON","STEVEN","P","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19670511","3649 DANE RD","OWATONNA","MN","55060","1128b4","20250820","00000000","00000000",""
"JONES","JESSICA","N","","IND- LIC HC SERV PRO","NURSE/NURSES AIDE","","0000000000","19910730","233 W COLLEGE AVENUE, APT A2","MONTICELLO","AR","71655","1128a2","20250820","00000000","00000000",""
"JOOF","SAJUKA","","","EMPLOYEE - PRIVATE S","ADULT HOME","","0000000000","19620907","44 BRATTLE STREET","PROVIDENCE","RI","02907","1128a2","20250820","00000000","00000000",""
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