Maryann H. Pass, CNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

209001958 Issued in IL

Practice address

2 Memorial Dr
Suite 122
Alton, IL 62002-6723

Phone

(618) 465-2550

Fax

(618) 462-4167

NPI assigned

Dec 29, 2006

Last updated

Oct 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Maryann H. Kopperman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1649336116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR",
            "address_2": "SUITE 122",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026723",
            "telephone_number": "618-465-2550",
            "fax_number": "618-462-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR",
            "address_2": "SUITE 122",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026723",
            "telephone_number": "618-465-2550",
            "fax_number": "618-462-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASS",
        "first_name": "MARYANN",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "123658",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209001958",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041272946",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "123658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANN",
            "last_name": "KOPPERMAN",
            "middle_name": "H.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meredith Anne Parker, MSW, LCSW
• Samantha Lynn Parker, PHARMD
• Lacy Parks, BSED
• Parkway Physical Therapy LLC
• Karlee Paslay, BA
• Bindu N Patel, MD
• Jagannath Patil, MD
• Nikita Patil
• Pec Alton, LLC (Performance Eyecare)
• Sarah Joy Pechtl, SLP

• Women's Health Nurse Practitioner in Alton, IL
• Providers in Alton, IL by specialty
• Women's Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.