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DATA PERSONIL TENAGA KEPERAWATAN

RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN


JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Su'ib, S.Kep.Ners L Gresik, 28/07/1969 Ners / 2012 PERAWAT Perawat Madya PNS 01/02/1990 P2T/3998/03.02/02/VIII/2018 s/d 28/07/2023 3658/SIPP.I/413.111/XI/2018.P1 s/d 28/07/2023
2 Nur Lely Idayanti, A.Md.Kep P Lamongan, 22/06/1979 Ners / 2013 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/2056/03.02/02/V/2019 s/d 22-06-2024 2168/SIPP.I/413.111/VIII/2019.P1 s/d 22-06-2024

3 Dina Kurnia Rahayu, A.Md.Kep P Lamongan, 20 -04- 1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/3537/03.02/02/V/2016 s/d 20/04/2021 189/SIPP/VI/2016 s/d 20/04/2021
4 Risnita Arsanti, S.ST
5 Suwarti, A.Md.Keb
6 Naneng Khasanah, A.Md.Keb
7 Sukhimeiyarsih, S.Kep.Ners P Lamonngan, 25/05/1969 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1991 16 01 7 2 1 15-1039503 s/d 22-05-2020 2028/SIPP.I/413.111/V/2018.P1 s/d 22-05-2020
8 Ani Mahmudah, A.Md.Keb
9 Giyani, S.Kep.Ners P Sragen, 31/08/1976 Ners / 2013 PERAWAT Perawat Pertama PNS 01-12-2003 P2T/1941/03.02/02/VII/2019 s/d 31-08-2024 2291/SIPP.I/413.111/VIII/2019.P1 s/d 31-08-2024

10 Yasin, A.Md.Kep L Lamongan, 22/03/1965 D3 Keperawatan / 2000 PERAWAT Perawat Penyelia PNS 01-03-1989 P2T/2193/03.02/02/III/2018 s/d 22/03/2023 2375/SIPP/I/413.111/VII/2018.P1 s/d 22/03/2023

11 Wahyu Suprihatin, A.Md.Kep P Lamongan, 15/03/1981 D3 Keperawatan / 2002 PERAWAT Perawat Penyelia PNS 01-03-2003 P27/798/03.02/02/II/2019 s/d 15-03-2024 2167/SIPP.I/413.111/VIII/2019.P1 s/d 15-03-2024

12 Sunarjo, S.Kep, Ns L Lamongan, 16/04/1976 Ners / 2013 PERAWAT Perawat Muda PNS 01-03-1997 P2T/2383/03.02/01/II/2017 s/d 16/04/2022 217/SIPP/VIII/2017 s/d 16/04/2022
13 A. Muhajir, S.Kep.Ners L Lamongan, 07/07/1965 Ners / 2011 PERAWAT Perawat Madya PNS 01/03/1989 P2T/5208/03.02/02/VI/2017 s/d 17/07/2022 3.684/SIPP.I/413.111/XI/2018.P1 s/d 17/07/2022

14 Marno, A.Md.Kep L Lamongan, 13/04/1965 D3 Keperawatan / 2009 PERAWAT Perawat Penyelia PNS 01/03/1991 P2T/803/03.02/02/II/2019 s/d 13/04/2024 567/SIPP.I/413.111/III/2019.P1 s/d 13/04/2024
15 Nur Isworo, S.Kep.Ns L Lamongan, 04/10/1975 Ners / 2013 PERAWAT Perawat Muda PNS 01/03/1997 P2T/1968/03.02/01/II/2014 s/d 04-10-2019 200/SIK.P/V/2014 s/d 04-10-2019
16 Luqman Puji Inggrahan, A.Md.RO
17 Ristunik, S.Kep.Ners P Malang, 19/11/1968 Ners / 2014 PERAWAT Perawat Madya PNS 01-12-1994 16 01 7 2 1 15-1039502 s/d 19/11/2020 3656/SIPP.I/413.111/XI/2018/P1 s/d 19/11/2020

18 Arum Sulistyowati, s.Kep.Ners P Lamongan, 27/08/1980 Ners / 2016 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/8769/03.02/01/X/2017 s/d 27/08/2020 647/SIPP/XII/2017 s/d 27/08/2020
19 Lilis Mamik,S.Kep.Ners P Lamongan, 14/11/1979 Ners / 2013 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/4340/30.02/01/VI/2016 s/d 14/11/2021 227/SIPP/VII/2016 s/d 14/11/2021
20 Uslan, A.Md.Kep L Lamongan, 27/01/1972 Ners / 2013 PERAWAT Perawat Penyelia PNS 01/03/1994 P2T/25114/03.02/01/III/2015 s/d 27/01/2020 503/SIPP/XII/2016 s/d 27/01/2020
21 Lewy Andria, A.Md.Kep P Bojonegoro, 29/08/1978 D3 Keperawatan / 2000 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/429/03.02/01/I/2015 s/d 20-08-2020 61/SIK.P/III/2015 s/d 20-08-2020
22 Elif Rohana E
23 M. Hasyim.B, A.Md.Kep L Gresik, 13/04/1962 D3 Keperawatan / 2005 PERAWAT Perawat Penyelia PNS 01-12-1984 P2T/5129/03.02/02/VIII/2016 s/d 13/04/2021 262/SIPP/VIII/2016 s/d 13/04/2021
24 Erna Rokhmawati, A.Md.Kep P Lamongan, 22/07/1985 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/7717/03.02/02/XI/2016 s/d 28/07/2021 533/SIPP/X/2017 s/d 28/07/2021
25 Zunti Masruroh, S.Kep.Ners P Lamongan, 25/02/1975 Ners / 2014 PERAWAT Perawat Muda PNS 01-12-2000 P2T/6994/03.02/01/VI/2015 s/d 25/02/2020 222/SIPP/VII/2016 s/d 25/02/2020
26 Andik Winarno, A.Md L Lamongan, 23/04/1980 D3 Kes Gigi / 2011 PERAWAT Perawat Gigi PNS 01/04/2006 16 04 5 1 1 17-2095275 s/d 23/04/2022 4092/SIPTGM/413.111/XII/2018.P1 s/d
Pelaksana 23/04/2022
27 Tukiran
28 Ach. Marzuki, A.Md.Kep L Lamongan, 12/07/1969 Ners / 2014 PERAWAT Perawat Muda PNS 01/03/1997 16 01 7 1 1 15-1039496 s/d 12-07-2020 82/SIPP/II/2017 s/d 12-07-2020
29 Sugianto L Lamongan, 30/01/1969 SPK / 1988 PERAWAT Perawat Penyelia PNS 01-03-1989 P2T/1985/03.02/02/III/2018 s/d 17/10/2020 3484/SIPP.I/413.111/X/2018.P1 s/d 17/10/2020
30 Mochamad Rochim, A.Md.Kep L Lamongan, 12/10/1977 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/2024/03.02/01/II/2017 s/d 12/10/2022 105/SIPP/III/2017 s/d 12/10/2022
31 Moh. Haris Shodiq
32 Endang Sukeniati, A.Md.Kep P Lamongan, 26/05/1964 D3 Keperawatan / 2000 PERAWAT Perawat Penyelia PNS 01/03/1987 P2T/16622/03.02/01/XII/2015 s/d 26/05/2020 433/SIPP/XI/2016 s/d 26/05/2020
33 Nellis Verlinalasa, A.Md.Kep P Tuban, 20/01/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/3441/03.02/02/VII/2018 s/d 20/01/2023 326/SIPP.I/413.111/II/2019.P1 s/d 20/01/2023
34 Indarwati
35 Suhaji, S.Kep, Ns L Lamongan, 01/08/1966 Ners / 2011 PERAWAT Perawat Muda PNS 01/03/1985 P2T/6767/03.02/02/VII/2017 s/d 01/08/2022 316/SIPP/VIII/2017 s/d 01/08/2022
36 Lilik Suryani, A.Md.Kep P Lamongan, 22/03/1967 D3 Keperawatan / 2005 PERAWAT Perawat Penyelia PNS 01/01/1988 P2T/2392/03.02/02/III/2018 s/d 22/03/2023 2716/SIPP.I/413.111/VII/2018.P1 s/d 22/03/2023

37 Hartini, S.Kep.Ners P Lamongan, 26/02/1981 Ners / 2013 PERAWAT Perawat Pertama PNS 01/04/2006 P2T/512/03.02/02/II/2019 s/d 26/02/2024 536/SIPP.I/413.111/III/2019.P1 s/d 26/02/2024
38 Mardi, A.Md.Kep L Lamongan, 02/09/1966 D3 Keperawatan / 2018 PERAWAT Perawat Penyelia PNS 08-08-2008 16 01 5 1 1 18-1582665 s/d 02/09/2023 290/SIPP.I/413.111/II/2019.P1 s/d 02/09/2023
39 Kasmulin, S.Kep.Ns L Lamongan, 04/06/1967 Ners / 2014 PERAWAT Perawat Madya PNS 01-03-1989 P2T/7175/03.02/01/VIII/2017 s/d 04/06/2022 567/SIPP/X/2017 s/d 04/06/2022
40 Haria Sidiana, A.Md.Kep P Lamongan, 09/10/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/354/03.02/01/I/2015 s/d 09-10-2020 60/SIK.P/III/2015 s/d 09-10-2020
41 Tutut Supiatun, A.Md.Kep P Lamongan,05/12/1982 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/5781/03.02/02/XII/2018 s/d 05-12-2023 245/SIK.P/VIII/2013 s/d 05-12-2023
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
42 Imam Kanafi, S.Kep.Ners L Lamongan, 26/05/1973 Ners / 2013 PERAWAT Perawat Penyelia PNS 01/03/1995 P2T/1975/03.02/01/II/2014 s/d 26/05/2019 2791/SIPP.I/314.111/VII/2018.P1 s/d 26/05/2019

43 Genduk Linah P Lamongan, 07/04/1981 PERAWAT Perawat Kontrak 01/01/2008 P2T/3535/03.02/V/2016 s/d 17-10-2020 188/SIPP/VI/2016 s/d 17-10-2020
Pemda
44 Sumarji, A.Md.Kep L Lamongan, 04/06/1973 Ners / 2014 PERAWAT Perawat Muda PNS 01/03/1994 16 01 7 1 1 18-1551910 s/d 04-06-2023 3916/SIPP.I/413.111/III/2018.P1 s/d 04-06-2023
45 Dwi Mei Karyanti, A.Md.Kep P Lamongan, 02/05/1977 Ners / 2014 PERAWAT Perawat Mahir PNS 01-12-2003 P2T/11023/03.02/02/XII/2014 s/d 02/05/2019 201/SIK.P/VII/2015 s/d 02/05/2019
46 Nurul Chamidah
47 Suwito, S.Kep, Ns L Lamongan, 14/10/1969 Ners / 2011 PERAWAT Perawat Madya PNS 01-02-1990 P2T/7255/03.02/02/VIII/2017 s/d 14/10/2022 420/SIPP/VIII/2017 s/d 14/10/2022
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Umi Sa'adah, S.Kep.,Ns P Lamongan, 30/08/1969 Ners / 2011 PERAWAT Perawat Madya PNS 01-02-1989 P2T/6766/03.02/02/VII/2017 s/d 30/08/2022 708/SIPP/XII/2017 s/d 30/08/2022
2 Aan Masyruki, A.Md.Kep L Lamongan, 10-05-1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/08/2007 P2T/992/03.02/02/XI/2016 s/d 10/05/2021 562/SIPP/XII/2016 s/d 10/05/2021
3 Helmi Airlangga, A.Md.Kep L Lamongan, 25/10/1979 Ners / 2014 PERAWAT Perawat Pertama PNS 01-12-2003 16 01 7 1 1 15-1039498 s/d 25/10/2020 58/SIK.P/III/2015 s/d 25/10/2020
4 Afiyatur Rofiah, A.Md.Kep P Lamongan, 26-10-1986 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2009 P2T/7971/03.02/02/IX/2017 s/d 27-10-2022 701/SIPP/XII/2017 s/d 27-10-2022
5 Qurrota A'yun, A.Md.Kep P Lamongan, 01-10-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/5116/03.02/02/X/2018 s/d 01/10/2023 4041/SIPP.I/413.111/XII/2018.P1 s/d 01/10/2023

6 Akhmad Safari Fajjri, S.Kep.Ns L Sumenep, 08-10-1987 Ners / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7986/03.02/01/IX/2017 s/d 08-10-2022 702/SIPP/XII/2017 s/d 08-10-2022
7 Anis Yuli Setyowati, A.Md.Kep P Lamongan, 26 -07-1981 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/2702/03.02/02/VII/2019 s/d 26/07/2024 2110/SIPP.I/413.111/VII/2019.P1 s/d 26/07/2024

8 Benny Candra Topan, S.Kep.Ners L Lamongan, 04/01/1987 Ners / 2014 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/6940/03.02/01/VIII/2017 s/d 04/01/2022 503/SIPP/IX/2017 s/d 04/01/2022
9 Vidi Nurtama, A.Md.Kep L Lamongan, 30-06-1988 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2012 P2T/7565/03.02/01/VII/2015 s/d 30/07/2020 238/SIPP/VII/2016 s/d 30/07/2020
10 Imam Bukhori, A.Md.Kep L Lamongan, 03/07/1983 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/6863/03.02/02/X/2016 s/d 03-07-2021 152/SIPP/IV/2017 s/d 03-07-2021
11 Mardiyah Purwatiningsih, A.Md.Kep P Lamongan, 03-04-1981 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/3443/03.02/02/VII/2018 s/d 03-04-2023 3659/SIPP.I/413.111/XI/2018.P1 s/d 03-04-2023
12 Nur Kholifah, A.Md.Kep P Lamongan, 24-06-1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/6861/03.02/02/X/2016 s/d 24-06-2021 149/SIPP/IV/2017 s/d 24-06-2021
13 Pitra Sari Mahatmi, A.Md.Kep P Lamongan, 14/07/1986 D3 Keperawatan / PERAWAT Perawat Kontrak 01/07/2008 P2T/9067/03.02/02/XI/2017 s/d 14/06/2022 648/SIPP/XII/2017 s/d 14/06/2022
Pemda
14 Siti Umaiyyah, A.Md.Kep P Lamongan, 11/05/1981 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/355/03.02/01/I/2015 s/d 11-05-2020 59/SIK.P/III/2015 s/d 11-05-2020
15 Titik Nurhidayati, A.Md.Kep P Lamongan, 17/12/1982 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/114/03.02/01/I/2015 s/d 17/12-2020 240/SIPP/VII/2016 s/d 17/12-2020
16 Vivin Frank Land Man, A.Md.Kep L Lamongan, 20-02-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/618/03.02/02/I/2016 s/d 20/02/2021 151/SIPP/IV/2017 s/d 20/02/2021
17 Anreka Yudha Timor, A.Md.Kep L Lamongan, 21-1-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/519/03.02/01/I/2017 s/d 21-11-2022 602/SIPP/XI/2017 s/d 21-11-2022
18 Sri Wahyuni, A.Md.Kep P Lamongan, 23 juli 1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/11678/03.02/01/XI/2015 s/d 23-07-2020 605/SIPP/XI/2017 s/d 23-07-2020
19 Ighna Masfiatun Afifah, A.Md.Kep P Lamongan, 12-07-1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 12 01 5 2 1 16-2002332 s/d 28-06-2021 607/SIPP/XI/2017 s/d 28-06-2021
20 Riska Puji Lestari, A.Md.Kep P Lamongan, 14-09-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8879/03.02/01/XII/2016 s/d 14-09-2021 603/SIPP/XI/2017 s/d 14-09-2021
21 Agung Purnomo, A.Md.Kep L Lamongan, 6 oktober 1990 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/7977/03.02/02/IX/2017 s/d 04-10-2022 608/SIPP/XI/2017 s/d 04-10-2022
22 Nur Lia Anggraini, A.Md.Kep P Lamongan, 04-01-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8678/03.02/01/XI/2016 s/d 04/01/2021 606/SIPP/XI/2017 s/d 04/01/2021
23 Hevi Eka Candra Febrianti, A.Md.Kep P Lamongan, 29 februari 1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8804/03.02/01/XI/2016 s/d 29-02-2021 604/SIPP/XI/2017 s/d 29-02-2021

24 Iva Wahyuningsih, A.Md.Kep P Lamongan, 08/06/1981 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/9071/03.02/02/XI/2017 s/d 08-06-2022 625/SIPP/XI/2017 s/d 08-06-2022
25 Ni’matus Sa’diyah, A.Md.Kep P Lamongan, 11/04/1989 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/433/03.02/02/I/2015 s/d 11/04/2020 204/SIPP/VI/2016 s/d 11/04/2020
26 Yeti Arvika Rini, A.Md.Kep P Lamongan, 26 oktober 1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/11620/03.02/01/XI/2015 s/d 26-10-2020 589/SIPP/XI/2017 s/d 26-10-2020

27 Rosita, A.Md.Kep P Lamongan, 22 desember D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8921/03.02/01/XII/2016 s/d 22-12-2021 324/SIPP/VIII/2017 s/d 22-12-2021
1994
28 Alwanul Ulum, A.Md.Kep L Lamongan, 09-08-1989 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2013 P2T/8632/03.02/02/X/2017 s/d 03-08-2022 724/SIPP/VIII/2017 s/d 03-08-2022
29 M. Iltizamul khoiri, A.Md.Kep L Lamongan, 19-11-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 160151118-2390358 s/d 19-11-2023 1988/SIP.I/413.111/VII/2019.P1 s/d 19-11-2023
30 Jeni Meldiati, A.Md.Kep P Lamongan, 07-04-1986 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2012 P2T/2839/03.02/02/IV/2018 s/d 07/04/2023 2236/SIPP.I/413.111/VI/2018.P1 s/d 07/04/2023
31 Abdul Ghoni Azmi, S.Kep.Ners L Lamongan, 7 juli 1993 Ners / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8437/03.02/01/XI/2016 s/d 07/07/2021 277/SIPP/VII/2017 s/d 07/07/2021
32 Moch. Rizki Alfan Tinno, A.Md.Kep L Lamongan, 17 september D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/12766/03.02/01/XI/2015 s/d 17-09-2020 332/SIPP/VIII/2017 s/d 17-09-2020
1994
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
INSTALASI HEMODIALISA
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Subadi, S.Kep.Ners L Lamongan, 04/07/1969 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1991 16 01 7 1 1 15-0978082 s/d 04/07/2020 3460/SIPP.I/314.111/X/2018.P1 s/d 04/07/2020
2 Ach Na’im, S.Kep.Ners L Lamongan, 17/08/1974 Ners / 2014 PERAWAT Perawat Muda PNS 01/03/1996 P2T/6794/03.02/01/V/2015 s/d 27/08/2020 431/SIPP/XXI/2016 s/d 27/08/2020
3 Choirun Niswatin, A.Md.Kep P Lamongan, 20/10/1985 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/78372/03.02/02/X/2017 s/d 20/10/2022 545/SIPP/X/2017 s/d 20/10/2022
4 Kartono, S.Kep.Ners L Lamongan, 16/11/1972 Ners / 2014 PERAWAT Perawat Mahir PNS 01/03/1997 16 01 7 1 1 15-0978067 s/d 16/11/2020 432/SIPP/XI/2016 s/d 16/11/2020
5 Nita Dewi Indayani, A.Md.Kep P Lamongan, 16/11/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1981/03.02/01/II/2011 s/d 16/11/2022 94/SIPP/III/2017 s/d 16/11/2022
6 Riri Kusuma Wati, A.Md.Kep P Lamongan, 08/02/1987 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/2008/03.02/02/II/2016 s/d 06/02/2021 430/SIPP/XI/2016 s/d 06/02/2021
7 Umi Sa’adah, S.Kep.Ners P Sidoarjo, 09/11/1976 Ners / 2016 PERAWAT Perawat Penyelia PNS 01-12-2000 P2T/1649/03.02/01/II/2017 s/d 09/11/2022 95/SIPP/III/2017 s/d 09/11/2022
8 Sigit Ardiawan, S.Kep.Ners L Lamongan, 22/10/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/6769/03.02/01/VII/2017 s/d 22-10-2020 502/SIPP/IX/2017 s/d 22-10-2020
9 Alimatus Sa'diyah, A.Md.Kep P Lamongan, 21-06-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/4057/03.02/02/VIII/2018 s/d 21/06/2023 3459/SIPP.I/413.111/X/2018.P1 s/d 21/06/2023
10 Anang Heru K, A.Md.Kep L Lamongan, 17-06-1983 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/911/03.02/02/I/2014 s/d 07/06/2019 32/SIK.P/I/2014 s/d 07/06/2019
11 Addy Budi Purwanto, S.Kep.Ners L Lamongan, 18/12/1989 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/195/03.02/02/I/2015 s/d 18/12/2020 256/SIK.P/VIII/2015 s/d 18/12/2020
12 Aan Masyruki, A.Md.Kep L Lamongan, 10-05-1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/08/2007 P2T/992/03.02/02/XI/2016 s/d 10/05/2021 562/SIPP/XII/2016 s/d 10/05/2021
13 Nur Aminuddin, A.Md.Kep L Lamongan, 12/05/1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/6915/03.02/02/VIII/2017 s/d 12/05/2022 2381/SIPP.I/413.111/VII/2018 s/d 12/05/2022
14 Rizal Yusuf Fauzi Pramono
15 Ridhifian Arifianto
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Suiswanto, S.ST L Lamongan, 12/05/1977 D4 Keperawatan / 201I PERAWAT Perawat Mahir PNS 01-12-2003 16 01 6 1 1 16-1115683 s/d 12/05/2021 2029/SIPP.I/413.111/V/2018.P1 s/d 12/05/2021
2 Sri Indrawati, A.Md.Kep P Lamongan, 04/11/1982 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/01/2007 P2T/37/03.02/01/I/2015 s/d 04/11/2020 37/SIK.P/I/2015 s/d 04/11/2020
3 Sri Sudarwati, A.Md.Kep P Lamongan, 04/04/1980 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/320/03.02/01/I/2015 s/d 04/04/2020 34/SIK.P/I/2015 s/d 04/04/2020
4 Risa, A.Md.Kep P Lamongan, 27/05/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/5586/03.02/02/IV/2014 s/d 27/05/2019 232/SIK.P/VI/2014 s/d 27/05/2019
5 Nur Choerun Azari, A.Md.Kep L Lamongan, 23 -05 -1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/7237/03.02/02/X/2016 s/d 23/05/2021 555/SIPP/XII/2016 s/d 23/05/2021
6 Ahmad Rifa’i Subagiyo, S.Kep.Ners L Lamongan, 15/02/1985 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/7988/03.02/01/XI/2016 s/d 15/02/2021 165/SIPP/VIII/2017 s/d 15/02/2021
7 Nurhayati Dwi Sulistyoningsih, A.Md.Kep P Lamongan, 04/10/1989 D3 Keperawatan / 2010 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/11426/03.02/02/X/2015 s/d 04/10/2020 394/SIK.P/XII/2015 s/d 04/10/2020
8 Syangga Diwangga, A.Md.Kep L Lamongan, 26-04-1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/1454/03.02/02/III/2019 s/d 26/04/2024 1828/SIPP.I/413.111/VI/2019.P1 s/d 26/04/2024
9 Ida Rahmawati, A.Md.Kep P Lamongan, 04/05/1986 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/9130/03.02/02/XI/2017 s/d 04-05-2022 626/SIPP/XI/2017 s/d 04-05-2022
10 Dian Eka Kurniawati, A.Md.Kep P Lamongan, 22/06/1983 D3 Keperawatan / 2005 PERAWAT Perawat mahir PNS 01/01/2010 P2T/15519/03.02/02/XI/2015 s/d 22/07/2020 395/SIPP/XI/2016 s/d 22/07/2020
11 Rini Widyastutik , A.Md.Kep P Lamongan, 16/02/1984 D3 Keperawatan / PERAWAT Perawat Kontrak 01/02/2008 P2T/3536/03.02/02/V/2016 s/d 16/02/2021 192/SIPP/VI/2016 s/d 16/02/2021
Pemda
12 Saufa Kusnayati, A.Md.Kep P lamongan, 8 agustus 1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8904/03.02/01/XII/2016 s/d 08-08-2021 283/SIPP/VII/2017 s/d 08-08-2021
13 Muh. Dimas Anang Bahari, A.Md.Kep L Lamongan, 19-8-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/9030/03.02/01/XII/2016 s/d 19-08-2021 646/SIPP/XI/2017 s/d 19-08-2021
14 Eka Indah Setiani, A.Md.Kep P Lamongan, 23-05-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/1871/03.02/02/IV/2019 s/d 23-05-2024 1653/SIPP.I/413.111/V/2019.P1 s/d 23-05-2024
15 Ratna Watiningsih, A.Md.Kep P Lamongan, 13 -03-1983 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/797/03.02/02/II/2019 s/d 13/03/2024 711/SIPP.I/413.111/IV/2019.P1 s/d 13/03/2024
16 Karnadi, A.Md.Kep L Lamongan, 05/02/1978 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 16 01 7 1 1 15-1039499 s/d 05-02-2020 384/SIPP/XI/2016 s/d 05-02-2020
17 Naimatun, A.Md.Kep P Lamongan, 08/06/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/9065/03.02/02/XI/2017 s/d 08/06/2022 629/SIPP/XI/2017 s/d 08/06/2022
18 Dzakiy Muhandis, S.Kep.Ners L Lamongan., 21 januari 1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10153/03.02/01/X/2015 s/d 21-01-2020 628/SIPP/XI/2017 s/d 21-01-2020

19 Wieke Artanty Puspitasari, S.Kep.Ners P Lamongan, 14-11-1987 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8899/03.02/02/X/2017 s/d 14/11/2022 609/SIPP/XI/2017 s/d 14/11/2022
20 Rahardian Dias Perdana, A.Md.Kep L Lamongan, 23 desember D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 160151118-2391380 s/d 23-12-2023 1975/SIP.I/413.111/VII/2019.P1 s/d 23-12-2023
1991
21 Siti Rohmawati A.Md.Kep P Lamongan, 23/11/1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/9986/03.02/01/XII/2017 s/d 23/11/2022 2254/SIPP.I/413.111/VIII/2019 s/d 23/11/2022
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG ICU
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Mustadi, S.Kep., NS L Lamongan, 15/02/69 Ners / 2011 PERAWAT Perawat Muda PNS 01-03-1990 P2T/622/03.02/02/I/2017 s/d 15/02/2022 52/SIPP/II/2017 s/d 15/02/2022
2 Abdul Khohar, A.Md.Kep L Lamongan, 04/09/1977 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/4235/03.02/02/IX/2018 s/d 04-09-2023 3662/SIPP.I/314.111/XI/2018.P1 s/d 04-09-2023
3 Fathurrohman, A.Md.Kep L Lamongan, 18/02/1979 D3 Keperawatan/ 2002 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1435/03.02/02/III/2019 s/d 18-02-2024 2171/SIPP.I/413.111/VIII/2019.P1 s/d 18-02-2024

4 Fita Fatimah, A.Md.Kep P Gresik, 17-10-1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/35/03.02/01/I/2015 s/d 17/10/2020 36/SIK.P/I/2015 s/d 17/10/2020
5 Khayatun Fitriyah, A.Md.Kep P Lamongan, 22/12/1985 D3 Keperawatan/ 2009 PERAWAT Perawat Mahir PNS 01-01-2011 P2T/172/03.02/02/I/2015 s/d 22-12-2020 23/SIK.P/I/2015 s/d 22-12-2020
6 Lisa Umami, S.Kep.Ners P Lamongan, 05/03/1981 Ners / 2015 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1662/03.02/01/II/2017 s/d 05/03/2022 93/SIPP/III/2017 s/d 05/03/2022
7 Nur Asiya, A.Md.Kep P Lamongan, 25/08/1980 Ners /2016 PERAWAT Perawat Pertama PNS 01/04/2006 P2T/1582/03.02/01/I/2017 s/d 25/08/2022 90/SIP.P/III/2017 s/d 25/08/2022
8 Piah, A.Md.Kep P Lamongan, 19/10/1977 D3 Keperawatan/ 2009 PERAWAT Perawat Pelaksana PNS 01/04/2006 P2T/5483/03.02/02/X/2018 s/d 19/10/2023 4039/SIPP.I/413.111/XII/2018.P1 s/d 19/10/2023

9 Siti Fadhilah, A.Md.Kep P Lamongan, 15/05/1982 D3 Keperawatan/ 2003 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/36/03.02/01/I/2015 s/d 15/05/2020 35/SIK.P/I/2015 s/d 15/05/2020
10 Umu Choiriyah, A.Md.Kep P Lamongan, 19/03/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1556/03.02/02/I/2017 s/d 19/03/2022 92/SIPP/III/2017 s/d 19/03/2022
11 Cicik Mashula, A.Md.Kep P 3524154909790003 D3 Keperawatan / 2000 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/3986/03.02/02/III/2015 s/d 09/09/2020 125/SIK.P/IV/2015 s/d 09/09/2020
12 Toni Yulianto, A.Md.Kep L Lamongan, 22/07/1983 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/616/03.02/02/I/2016 s/d 22-07-2021 225/SIPP/VII/2016 s/d 22-07-2021
13 Habibi Ika Kurnianto, A.Md.Kep L Lamongan, 11-01-1986 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2009 P2T/10600/03.02/02/XII/2016 s/d 11/01/2021 4042/SIPP.I/413.111/XII/2018.P1 s/d 11/01/2021

14 Yulikah, A.Md.Kep P Lamongan, 16-01-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/613/03.02/02/I/2016 s/d 16-01-2021 224/SIPP/VII/2016 s/d 16-01-2021
15 Eko Yulianto Kuswandono, A.Md.Kep L Lamongan, 25/07/1983 Ners / 2013 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/7627/03.02/01/VII/2015 s/d 25-07-2020 217/SIK.P/VII/2015 s/d 25-07-2020
16 Arifatul Fauziyah, A.Md.Kep P Lamongan, 09-03-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 160152118-2391431 s/d 09/03/2023 1976/SIPP.I/413.111/VII/2019.P1 s/d 09/03/2023
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Aji Suyono, S.Kep.Ners L Bojonegoro, 04/10/1969 Ners / 2011 PERAWAT Perawat Muda PNS 01/12/2000 P2T/8879/03.02/02/X/2017 s/d 04/10/2022 949/SIPP.I/413.111/III/2018.P1 s/d 04/10/2022
2 Abdul Hamid, A.Md.Kep L Lamongan, 19-01-1989 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/7025/03.02/02/X/2016 s/d 19/01/2021 446/SIPP/XI/2016 s/d 19/01/2021
3 Aini Fatmawati, A.Md.Kep P Lamongan, 02/11/1983 D3 Keperawatan / 2006 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/5810/03.02/VIII/2016 s/d 02/11/2021 426/SIPP/XI/2016 s/d 02/11/2021
4 Puguh Jaya Setiawan, S.Kep.Ns L Lamongan, 11-08-1987 Ners / PERAWAT Perawat Kontrak BLUD 01/03/2013 P2T/4310/03.02/02/X/2018 s/d 11/08/2023 4107/SIPP.I/413.111/XII/2018.P1 s/d 11/08/2023

5 Bathi Susanto, A.Md.Kep L Lamongan, 22/07/1975 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 16 01 7 1 1 15-0978076 s/d 22/07/2020 164/SIPP/IV/2017 s/d 22/07/2020
6 Dian Anggraini, A.Md.Kep P Lamongan, 27/08/1981 Ners / 2018 PERAWAT Perawat Mahir PNS 01-12-2012 P2T/7222/03.02/02/VIII/2017 s/d 27/08/2022 642/SIPP/XIII/2017 s/d 27/08/2022
7 Faris Eko CP, A.Md.Kep L Lamongan, 15 -12- 1980 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 02/01/2008 P2T/9163/03.02/02/XI/2017 s/d 15/12/2022 2382/SIPP.I/413.111/VII/2018.P1 s/d 15/12/2022

8 Hasyim, A.Md.Kep L Lamongan, 05/05/1969 D3 Keperawatan / 2000 PERAWAT Perawat Penyelia PNS 01/03/1989 P2T/1/03.02/02/I/2019 s/d 05/05/2024 539/SIPP.I/413.111/III/2019.P1 s/d 05/05/2024
9 Indah Sulistyowati, A.Md.kep P Lamongan, 15-05-1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/2844/03.02/02/III/2017 s/d 15/05/2022 641/SIPP/XII/2017 s/d 15/05/2022
10 Iwan Sugandi, A.Md.Kep L Lamongan, 15-04-1987 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2009 P2T/766/03.02/02/I/2014 s/d 15/04/2019 425/SIPP/XI/2016 s/d 15/04/2019
11 Khoirun Nisaak F, A.Md.Kep P Serui, 29-06-1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/9064/03.02/02/XI/2017 s/d 19-07-2022 627/SIPP/XI/2017 s/d 19-07-2022
12 M. Agung Dwi Cahyono, A.Md.Kep L Lamongan, 08-02-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2013 P2T/1256/03.02/02/I/2017 s/d 08-02-2022 624/SIPP/XI/2017 s/d 08-02-2022
13 Moch. Syaeful Hudda, A.Md.Kep L Lamongan, 12/06/1983 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/684/03.02/02/I/2016 s/d 12/06/2021 4108/SIPP.I413.111/XII/2018.P1 s/d 12/06/2021
14 Ratna Hardini, A.Md.Kep P Lamongan, 08-05-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7540/03.02/01/IX/2014 s/d 08/05/2019 198/SIPP/VI/2016 s/d 08/05/2019
15 Rihatul Wardah, A.Md.Kep P Lamongan, 06/03/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/02/2015 P2T/306/03.02/02/I/2019 s/d 06/03/2024 533/SIPP.I/413.111/III/2019.P1 s/d 06/03/2024
16 Ristiyahwati, A.Md.Kep P Lamongan, 21-12-1983 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/11/2008 P2T/5550/03.02/01/IV/2015 s/d 21/12/2020 428/SIPP/XI/2016 s/d 21/12/2020
17 Rudy Hariyanto, A.Md.Kep L Lamongan, 03-06-1987 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2012 P2T/10561/03.02/02/X/2015 s/d 03/06/2020 406/SIPP/VIII/2017 s/d 03/06/2020
18 Suhadak H M, S.Kep.Ns L Lamongan, 15-06-1987 Ners / PERAWAT Perawat Kontrak BLUD 01/03/2014 16 01 7 1 1 18-2305913 s/d 15/07/2023 3657/SIPP.I/413.111/XI/2018.P1 s/d 15/07/2023
19 Tri Martiningtyas, S.kep.Ners P Malang, 01/03/1978 Ners / 2012 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/7106/03.02/01/VIII/2017 s/d 01/03/2022 640/SIPP/XII/2017 s/d 01/03/2022
20 Yulisvionita Ika PB,A.Md.Kep P Lamongan, 12-07-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/4243/03.02/02/IX/2018 s/d 12/07/2023 3654/SIPP.I/413.111/XI/2018.P1 s/d 12/07/2023
21 Zaeni, S.Kep.Ners L Lamongan, 16/01/1980 Ners / 2014 PERAWAT Perawat Pertama PNS 01/04/2006 16 01 7 1 1 15-0978083 s/d 16/01/2020 215/SIPP.I/413.111/I/2019.P1 s/d 16/01/2020
22 M. Masykur, S.Kep.Ners L Lamongan, 12-5-1989 Ners / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/2686/03.02/01/III/2015 s/d 12-05-2020 408/SIPP/VIII/2017 s/d 12-05-2020
23 M. Sholik Faidin, S.Kep.Ns L Lamongan, 26-09-1989 Ners / PERAWAT Perawat Kontrak BLUD 1/7/2014 P2T/5780/03.02/02/XII/2018 s/d 26/09/2023 470/SIPP.I/413.111/III/2019.P1 s/d 26/09/2023
24 Chintya Erlista Avidiana R.S, A.Md.Kep P Lamongan, 16-09-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8770/03.02/01/XI/2016 s/d 16/09/2021 317/SIPP/VIII/2017 s/d 16/09/2021
25 Virdiana Anggraini, A.Md.Kep P Lamongan, 20-07-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8796/03.02/01/XI/2016 s/d 20-07-2021 318/SIPP/VIII/2017 s/d 20-07-2021
26 Niswatul Lailiyah, A.Md.Kep P Lamongan, 9 maret 1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8931/03.02/01/XII/2016 s/d 09-03-2021 578/SIPP/XI/2017 s/d 09-03-2021
27 Catur Sugiharto, S.Kep.Ners
28 Nur Wenni Susanti, A.Md.Keb
29 Arminati Wardhani, A.Md.Keb
30 Chandra Ika P, A.Md.Keb
31 Sulastri, A.Md.Keb
32 Edi Suparto
33 Heru Prasetyo
34 Ilham Sudiono
35 Khoirul
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG IAR
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Mu'afah, S.Kep.Ns P Lamongan, 27/01/1962 Ners / 2011 PERAWAT Perawat Madya PNS 01-03-1984 P2T/1363/03.02/02/I/2017 s/d 27-01-2021 2/SIK.P/XII/2016 s/d 27-01-2021
2 Agus Suwandito, A.Md.Kep L Lamongan, 8 -08-1980 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/6886/03.02/02/X/2016 s/d 05/08/2022 05/SIPPA/VIII/2017 s/d 05/08/2022
3 Anastri Pavi Mindaria, A.Md.Kep P Pacitan, 04/04/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/10068/03.02/02/X/2015 s/d 04-04-2020 389/SIPP/XI/2016 s/d 04-04-2020
4 Doni Firmansah, A.Md.Kep L Lamongan, 25/05/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2010 161551116-1145663 s/d 25/05/2021 02/SIPPA/VIII/2017 s/d 25/05/2021
5 Endang Anik Yuliyah, A.Md.Kep P Lamogan, 24/01/1978 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/4457/03.02/02/III/2015 s/d 24-01-2020 09/SIPP/I/2016 s/d 24-01-2020
6 Jerry Pramono Putro, A.Md.Kep L Lamongan, 16/08/1978 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/5734/03.02/02/V/2014 s/d 16-08-2019 03/SIPPA/VIII/2017 s/d 16-08-2019
7 M. Ikhwan, A.Md.Kep L Lamongan, 31-12-1990 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/7024/03.02/02/X/2016 s/d 31-12-2021 445/SIPP/XI/2016 s/d 31-12-2021
8 Nunik Aliyah Ulfa, A.Md.Kep P Lamongan, 22/06/81 Ners / 2014 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/6993/03.02/01/VI/2015 s/d 22-06-2020 391/SIPP/XI/2016 s/d 22-06-2020
9 Suliana, A.Md.Kep P Lamongan, 27/09/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/5323/03.02/02/IV/2015 s/d 27-09-2020 390/SIPP/XI/2016 s/d 27-09-2020
10 Supardi, A.Md.Kep L Lamongan, 26/06/1974 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/12/2013 161551117-1443958 s/d 26-06-2022 01/SIPPA/VIII/2017 s/d 26-06-2022
11 Wahyu Nur Jannah, A.Md.Kep P Lamongan, 18-12-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7522/03.02/01/IX/2014 s/d 18-12-2019 200/SIPP/VI/2016 s/d 18-12-2019
12 Ahmad Susanto, A.Md.Kep L Lamongan, 28/04/1982 Ners / 2016 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/751/03.02/03/II/2019 s/d 28-04-2024 481/SIPP/XI/2016 s/d 28-04-2024
13 Siti Sridayati, A.Md.Kep P Lamongan, 14-10-1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/6862/03.02/02/X/2016 s/d 24/10/2021 150/SIPP/IV/2017 s/d 24/10/2021
14 Siti Nurjanah , A.Md.Kep P Lamongan, 25/12/1981 D3 Keperawatan / 2003 PERAWAT PNS 01/01/2007 P2T/1860/03.02/02/II/2018 s/d 25/12/2023 3248/SIPP.I/413.111/IX/2018.P1 s/d 25/12/2023
15 Nur Latifiah Fitriyanti, A.Md.Kep
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG IBS
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Nurul Chayatin, S.Kep, NS P Lamongan, 29/11/1976 Ners / 2002 PERAWAT Perawat Muda PNS 01/04/2006 P2T/3647/03.02/02/V/2016 s/d 29-11-2021 429/SIPP/XI/2016 s/d 29-11-2021
2 Abdul Muchid, A.Md.Kep L Lamongan, 25/06/1989 D3 Keperawatan / 2010 PERAWAT Perawat Mahir PNS 01/10/2011 P2T/10495/03.02/02/X/2015 s/d 25/06/2020 259/SIK.P/VIII/2013 s/d 25/06/2020
3 Abd. Rouf Khoiri, S.Kep.Ners L Lamongan, 16/08/1974 Ners / 2013 PERAWAT Perawat Muda PNS 01/01/2000 P2T/1989/03.02/01/II/2014 s/d 16/08/2019 62/SIPP/II/2017 s/d 16/08/2019
4 Afandi Mulyono, A.Md.Kep L Lamongan, 13/11/1977 Ners / 2016 PERAWAT Perawat Mahir PNS 01/12/2003 P2T/1840/03.02/01/II/2017 s/d 13/11/2022 485/SIIPP/XI/2016 s/d 13/11/2022
5 Cahya Taufiq Rakhman, A.Md.Kep L Lamongan, 06/01/1987 D3 Keperawatan / 2009 PERAWAT Perawat Mahir PNS 01-10-2011 P2T/1672/03.02/01/II/2015 s/d 06/01/2020 447/SIPP/XI/2016 s/d 06/01/2020
6 Dewi Ismauliyati, A.Md.Kep P Lamongan, 10 -12- 1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 02/01/2008 P2T/7463/03.02/02/XI/2016 s/d 10/12/2021 394/SIPP/XI/2016 s/d 10/12/2021
7 Asma’ul Husna, A.Md.Kep P Lamongan, 08/10/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/5548/03.02/01/IV/2015 s/d 08/10/2020 427/SIPP/XI/2016 s/d 08/10/2020
8 Evi Savitri, A.Md.Kep P Lamongan, 16-03-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/1888/03.02/02/III/2018 s/d 16/03/2023 3494/SIPP.I/413.111/X/2018.P1 s/d 16/03/2023
9 Hardika Yudhatama, S.Kep.Ns L Jakarta, 08-06-1990 Ners / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/259/03.02/01/I/2014 s/d 08/06/2019 422/SIPP/XI/2016 s/d 08/06/2019
10 Irfan Mahardika Crismiharso, A.Md.Kep L Lamongan, 17/08/1987 D3 Keperawatan / 2009 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/2302/03.02/01/III/2016 s/d 17-08-2021 655/SIPP/XII/2017 s/d 17-08-2021
11 Isti’anah, S.Kep.Ners P Lamongan, 25/10/1980 Ners / 2014 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/7110/03.02/01/VIII/2017 s/d 25/10/2022 653/SIPP/XII/2017 s/d 25/10/2022
12 Kholipah, A.Md.Kep P Lamongan, 14-07-1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 02/01/2008 P2T/3076/03.02/02/IV/2016 s/d 14-07-2021 396/SIPP/XI/2016 s/d 14-07-2021
13 Moh. Basuki , A.Md.Kep L Lamongan, 23/04/1981 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01-12-2003 P2T/712/03.02/02/II/2019 s/d 23/04/2024 s/d 23/04/2024
14 M. Nur ali, S.Kep.Ners L Lamongan, 15/11/1976 Ners / 2013 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/7210/03.02/01/VI/2015 s/d 15/11/2020 424/SIPP/XI/2016 s/d 15/11/2020
15 M. Sholeh, S.Kep.Ners L Lamongan, 17/04/1973 Ners / 2014 PERAWAT Perawat Penyelia PNS 01-03-1996 P2T/7108/02.03/01/VIII/2017 s/d 17/04/2022 1287/SIPP.I/413.111/IV/2018 s/d 17/04/2022
16 Nurhadi, A.Md.Kep L Lamongan, 20/07/1970 D3 Keperawatan / 2009 PERAWAT Perawat Penyelia PNS 01-02-1993 P2T/3077/03.02/01/IV/2016 s/d 20-07-2021 387/SIPP/XI/2016 s/d 20-07-2021
17 Pramono Adinata, A.Md.Kep L Lamongan, 26/01/1982 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/406/03.02/02/I/2016 s/d 20-01-2021 423/SIPP/XI/2016 s/d 20-01-2021
18 Ria Utami Widiastutik, A.Md.Kep P Lamongan, 31/08/1984 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01-01-2011 P2T/4338/03.02/02/VI/2016 s/d 31-08-2021 392/SIPP/XI/2016 s/d 31-08-2021
19 Rochmat Abdullah, A.Md.Kep L Lamongan, 04/02/1982 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/1189/03.02/02/II/2018 s/d 04/02/2023 3488/SIPP.I/413.111/X/2018 s/d 04/02/2023
20 Siswanto, A.Md.Kep L Surabaya, 15/12/1981 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/936/03.02/02/I/2016 s/d 15-12-2021 207/SIPP/XII/2017 s/d 15-12-2021
21 Sukriya Dini Puspawati, A.Md.Kep P Lamongan, 25/06/1978 D3 Keperawatan / 2006 PERAWAT PNS P2T/1850/03.02/02/II/2018 s/d 14/01/2023 3489/SIPP.I?413.111/X/2018 s/d 14/01/2023
22 Mukhamad Zudi, A.Md.Kep L Lamongan, 26/02/1984 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/2417/03.02/02/IV/2018 s/d 26/02/2023 2383/SIPP.I?413.111/VI/2018.P1 s/d 26/02/2023

23 Widiyawati, A.Md.Kep P Lamongan, 13 -01-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/3534/03.02/02/V/2016 s/d 13/01/2021 190/SIPP/VI/2016 s/d 13/01/2021
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG BOUGENVILE 4
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Sus Erna Suryani, S.Kep, Ns P Sumenep, 19/02/1967 Ners / 2010 PERAWAT Perawat Madya PNS 01-03-1995 P2T/4376/03.03/02/VI/2016 s/d 19/02/2021 957/SIPP.I/413.111/III/2018.P1 s/d 19/02/2021
2 Harun Rosyid,S.Kep.Ners L Lamongan, 16/10/1973 Ners / 2013 PERAWAT Perawat Muda PNS 01/03/1996 P27/1978/03.02/01/II/2014 s/d 16-10-2019 723/SIPP/VIII/2017 s/d 16-10-2019
3 Heffi Dwi Yulianti, A.Md.Kep P Lamongan, 08-07-1990 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2013 P2T/7630/03.02/02/XI/2016 s/d 08/07/2021 147/SIPP/IV/2017 s/d 08/07/2021
4 Sudarsono, A.Md.Kep L Lamongan, 29/09/1982 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/617/03.02/02/I/2016 s/d 29/09/2021 217/SIPP/VII/2016 s/d 29/09/2021
5 Ika Fiqiyati, A.Md.Kep P Lamongan, 15/09/1985 D3 Keperawatan / PERAWAT Perawat Kontrak 01/01/2010 P2T/5103/03.02/02/X/2018 s/d 15/09/2023 10/SIK.P/I/2014 s/d 15/09/2023
Pemda
6 Bangun Denny Setyawan, A.Md.Kep L Malang, 05-12-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7545/03.02/01/IX/2014 s/d 05-12-2019 212/SIPP/VIII/2016 s/d 05-12-2019
7 Hermi Astutik, S.Kep.Ns P Lamongan, 30-09-1985 Ners / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/403/03.02/01/I/2016 s/d 30/09/2021 226/SIPP/VII/2016 s/d 30/09/2021
8 Eka Yuliana Nur Anggraini, A.Md.Kep P Lamongan, 02-07-1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/11627/03.02/01/XI/2015 s/d 02-07-2020 384/SIPP/VIII/2017 s/d 02-07-2020
9 M. Syaiful Arif, A.Md.Kep L Lamongan, 23/10/1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 8/1/2018 P2T/7549/03.02/01/IX/2014 s/d 23/10/2019 2373/SIPP.I/413.111/VII/2018 s/d 23/10/2019
10 Fitri Zulyana, A.Md.Kep P Lamongan, 05/07/1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 8/1/2018 16 01 5 2 1 18-2245981 s/d 05/07/2023 3247/SIPP.I/413.111/IX/2018 s/d 05/07/2023
11 Ibrahim Sobirin, S.Kep.Ners L Lamongan, 23-7-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3174/03.02/02/VII/2019 s/d 23/07/2024 2299/SIPP.I/413.111/IX/2019.P1 s/d 23/07/2024
12 Weni Agustina, S.Kep.Ners P Wonogiri, 30-08-1991 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/10737/03.02/01/X/2015 s/d 30/08/2020 1827/SIPP.I/413.111/VI/2019 s/d 30/08/2020
13 Warokhmah Feriana Sari, A.Md.Kep P Lamongan, 25-02-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8684/03.02/01/XI/2016 s/d 25/02/2021 1649/SIPP.I/413.111/V/2019 s/d 25/02/2021
14 Evy Eka Indriyanti, A.Md.Kep P Gresik, 21/12/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 160152118-1596300 s/d 21/12/2023 1649/SIPP.I/413.111/V/2019 s/d 21/12/2023
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG DAHLIA 4
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Suwaji, S.Kep., NS L Lamongan, 25/07/1965 Ners / 2011 PERAWAT Perawat Madya PNS 01-01-1988 P2T/5207/03.02/02/VI/2017 s/d 25/07/2022 174/SIPP/XI/2017 s/d 25/07/2022
2 Nuroiniatul Hidayah, A.Md.kep P Lamongan, 04-11-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/5689/03.02/02/XI/2018 s/d 04-11-2023 4114/SIPP.I/413.111/XIII/2018.P1 s/d 04-11-2023

3 Eli Purdiawati, A.Md.Kep P Lamongan, 02 -01-1980 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2007 P2T/6196/03.02/01/V/2015 s/d 02/01/2020 364/SIPP/X/2016 s/d 02/01/2020
4 Elis Setiari, A.Md.Kep P Lamongan, 29-02-1984 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/1820/03.02/02/II/2017 s/d 29/02/2022 705/SIPP/XII/2017 s/d 29/02/2022
5 Samiadi, A.Md.Kep L Lamongan, 21-05-1981 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/11/2008 P2T/5692/03.02/02/XI/2018 s/d 21/05/2023 4044/SIPP.I/413.111/XII/2018.P1 s/d 21/05/2023

6 Ismi Badriyah, S.Kep.Ners P Lamongan, 11/06/1977 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/7300/03.02/01/VI/2015 s/d 11-06-2020 3485/SIPP.I/413.111/X/2018 s/d 11-06-2020
7 Fitriyatus Solikhah, A.Md.Kep P Lamongan, 29/07/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/4223/03.02/02/IX/2018 s/d 29-07-2023 4105/SIPP.I/413.111/XII/2018.P1 s/d 29-07-2023

8 Umi Mariati, S.Kep.Ners P Lamongan, 18/03/1980 Ners / 2012 PERAWAT Perawat Pertama PNS 01/04/2006 P2T/709/03.02/02/II/2019 s/d 18/03/2024 315/SIPP.I/413.111/III/2019.P1 s/d 18/03/2024
9 Ismi Azizah, A.Md.Kep P Lamongan, 5 nopember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11625/03.02/01/XI/2015 s/d 05-11-2020 279/SIPP/VII/2017 s/d 05-11-2020
1993
10 Wawan Widiyanto, A.Md.Kep L Lamongan, 02-06-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/1887/03.02/02/IV/2019 s/d 02-06-2024 1987/SIPP.I/413.111/VII/2019.P1 s/d 02-06-2024

11 Riska Prihantini, S.Kep.Ners P Lamongan, 19-4-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/232/03.02/02/I/2019 s/d 19-04-2024 s/d 19-04-2024
12 Zaitun Ulfa, A.Md.Kep P Lamongan, 03-05-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/1966/03.02/02/II/2017 s/d 03-04-2020 287/SIPP/VII/2017 s/d 03-04-2020
13 Felani Agus Susanto, A.Md.Kep L Lamongan, 5 agustus 1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10488/03.02/02/X/2015 s/d 05-08-2020 280/SIPP/VII/2017 s/d 05-08-2020
14 Erwin Suhartono, S.Kep.Ners L Lamongan, 08/08/1987 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/2813/03.02/02/VIII/2019.P1 s/d 08/08/2024 2890/SIPP.I/413.111/VIII/2019.P1 s/d 08/08/2024
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG SEROJA
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Nunuk Yasofah, S.Kep.Ners P Gresik, 12/06/1970 Ners / 2013 PERAWAT Perawat Muda PNS 01/03/1997 P2T/2043/03.02/02/V/2019 s/d 12/06/2024 2169/SIPP.I/413.111/VIII/2019.P1 s/d 12/06/2024

2 Moh. Doni Sokifyanto, A.Md.Kep L Lamongan, 18/01/1980 Ners / 2016 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/2023/03.02/01/II/2017 s/d 18/01/2022 482/SIPP/IX/2017 s/d 18/01/2022
3 M. Mahfud Shodri, A.Md.Kep L Lamongan, 24-02-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/1548/03.02/02/II/2018 s/d 24/02/2023 810/SIPP.I/413.111/III/2018.P1 s/d 24/02/2023
4 M. Zuli Hardiansyah, A.Md.Kep L Lamongan, 20-07-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 160151118-2374326 s/d 20/07/2023 2166/SIPP.I/413.111/VIII/2019.P1 s/d 20/07/2023

5 Moh. Afifullah Hanafi, A.Md.Kep L Lamongan, 21-03-1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/2780/03.02/02/III/2017 s/d 21/03/2022 722/SIPP/VIII/2017 s/d 21/03/2022
6 Ari Dyah Lestari, S.Kep.Ners P Lamongan, 11/08/1984 Ners / PERAWAT Perawat Mahir PNS 01/01/2010 P2T/762/03.02/01/I/2018 s/d 21/08/2023 715/SIPP/VIII/2017 s/d 21/08/2023
7 Renny Wulan Yunatiningsih, S.Kep.Ners P Jember, 31/05/1982 Ners / 2017 PERAWAT Perawat Mahir PNS 01/01/2007 P2T/3297/03.02/01/IV/2017 s/d 31/05/2022 291/SIPP.I/413.111/II/2019.P1 s/d 31/05/2022
8 Sekarwati, A.Md.Kep P Lamongan, 02/06/1983 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/9069/03.02/02/XI/2017 s/d 02/07/2022 623/SIPP/XI/2017 s/d 02/07/2022
9 Susila, A.Md.Kep L Lamongan, 18-01-1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/08/2015 P2T/197/03.02/02/I/2015 s/d 18/01/2020 383/SIPP/XI/2016 s/d 18/01/2020
10 Dinna Suci Wulan Safitri, A.Md.Kep P Lamongan, 10-03-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/765/03.02/02/I/2018 s/d 10/03/2023 008/SIPP.I/413.111/II/2018 s/d 10/03/2023
11 Nanik Susanti, S.Kep.Ners P Lamongan, 27-11-1986 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/13151/03.02/02/XI/2015 s/d 27/11/2020 335/SIPP/VIII/2017 s/d 27/11/2020
12 Intan Purvasi, A.Md.Kep P Lamongan, 15-07-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8979/03.02/01/XII/2016 s/d 15-07-2021 334/SIPP/VIII/2017 s/d 15-07-2021
13 Heri Setiawan, A.Md.Kep L Lamongan, 1 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160151118-2405651 s/d 01-12-2023 505/SIPP/IX/2017 s/d 01-12-2023
1992
14 Inayah, A.Md.Kep P Lamongan, 12 januari 1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152118-2404834 s/d 12-01-2023 2301/SIPP.I/413.111/IX/2019.P1 s/d 12-01-2023
15 Misbakhun Nizar, A.Md.Kep L Lamongan, 16-04-1988 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/315/03.02/02/I/2016 s/d 16-04-2021 451/SIPP/IX/2017 s/d 16-04-2021
16 Suliswanto, A.Md.Kep L Tuban, 9 mei 1988 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11427/03.02/02/X/2015 s/d 09/05/2020 631/SIPP/XI/2017 s/d 09/05/2020
17 Fita Novy Porwaningtyas, A.Md.Kep P Lamongan, 4 nopember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152118-2222319 s/d 04/11/2023 291/SIPP/VII/2017 s/d 04/11/2023
1993
18 Amlikhatus Shofa, A.Md.Kep P Lamongan, 27-10-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/7526/03.02/01/IX/2014 s/d 27-10-2019 551/SIPP/X/2017 s/d 27-10-2019
19 Nurul Anisa, A.Md.Kep P Lamongan, 5 agustus 1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3832/03.02/01/III/2014 s/d 05-08-2019 290/SIPP/VII/2017 s/d 05-08-2019
20 Aily Mufidah, A.Md.Kep P Lamongan, 18/10/1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/10066/03.02/01/XII/2017 s/d 18/10/2022 2378/SIPP.I/413.111/VII/2018 s/d 18/10/2022
21 Benny Afandi Purwanto, S.Kep.Ners L Lamongan, 06/09/1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/7724/03.02/01/IX/2017 s/d 06/09/2022 2377/SIPP.I/413.111/VII/2018 s/d 06/09/2022
22 Basuseno, S.Kep.Ners L Lamongan, 25/05/1988 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 7 1 1 18-2245104 s/d 25/05/2023 3245/SIPP.I/413.111/IX/2018 s/d 25/05/2023
376 Ayu Nova Safitri, A.Md.Kep P Lamongan, 01-05-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/885/03.02/01/I/2018 s/d 01/05/2023 1825/SIPP.I/413.111/VI/2019 s/d 01/05/2023
372 Deni Fariyanti, A.Md.Kep P Lamongan, 23-04-1997 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/447/03.02/01/II/2019 s/d 23/04/2024 1773/SIPP.I/413.111/VI/2019 s/d 23/04/2024
381 Rachmat Yayan Gunarto, A.md.Kep L Lamongan, 11/08/1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/742/03.02/02/II/2017 s/d 11/08/2024 1650/SIPP.I/413.111/V/2019 s/d 11/08/2024
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Kartono, SST L Lamongan, 21/12/1968 D4 Keperawatan Medikal PERAWAT Perawat Muda PNS 01-03-1995 P2T/5520/03.02/02/X/2018 s/d 21/12/2023 4106/SIPP.I/413.111/XII/2018.P1 s/d 21/12/2023
Bedah / 2012
2 Gunawan Edy Sulistiyanto, S.Kep.Ners L Lamongan, 31/10/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01-04-2006 P27/5710/03.02/01/XI/2018 s/d 31/09/20123 292/SIPP/413.111/II/2019.P1 s/d 31/09/20123
3 Deni Wahyuni Marfiati, A.Md.Kep P Lamongan, 27/12/1979 Ners / 2013 PERAWAT Perawat Mahir PNS 01-02-2009 P27/1966/03.02/01/II/2014 s/d 27/12/2019 126/SIK.P/IV/2015 s/d 27/12/2019
4 Dwi Yuni Aristi, A.Md.Kep P Lamongan, 04/06/1984 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS P2T/9073/03.02/02/XI/2017 s/d 04-06-2022 621/SIPP/XI/2017 s/d 04-06-2022
5 Erna Widayati, S.Kep.Ns P Lamongan, 24-04-1988 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/3035/03.02/02/V/2018 s/d 24-04-2023 3486/SIP.P/413.111/X/2018.P1 s/d 24-04-2023
6 Fakhrudin Arifatul Fatoni, A.Md.kep L Lamongan, 01-04-1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2012 P2T/10562/03.02/02/X/2015 s/d 01-04-2020 385/SIPP/XI/2016 s/d 01-04-2020
7 Sri Dian Ningseh, A.Md.Kep P Lamongan, 29/11/1987 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/760/03.02/01/I/2018 s/d 29/11/2023 010/SIPP.I/413.111/II/2018 s/d 29/11/2023
8 Sutarto, A.Md.Kep L Lamongan, 04-04-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/2779/03.02/02/III/2017 s/d 04-04-2022 719/SIPP/VIII/2017 s/d 04-04-2022
9 Tri Yuli Utami, A.Md.Kep P Lamongan, 27-07-1984 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/09/2015 P2T/4240/03.02/02/IX/2018 s/d 17/09/2023 386/SIPP/XI/2016 s/d 17/09/2023
10 Nis Srianti, S.Kep.Ners P Lamongan, 01/03/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/8764/03.02/01/X/2017 s/d 01-03-2022 727/SIP/VIII/2017 s/d 01-03-2022
11 Afik Dwi Saputro, A.Md.Kep L Lamongan, 01/12/1985 Ners / 2012 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/5482/03.02/02/X/2018 s/d 01/12/2023 4104/SIPP.I/413.111/XII/2018.P1 s/d 01/12/2023

12 Idawati, A.Md.Kep P Lamongan, 14 februari 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8912/03.02/01/XII/2016 s/d 14-02-2021 274/SIPP/VII/2017 s/d 14-02-2021

13 Eka Anggraini Aisyah, A.Md.Kep P Lamongan, 31 oktober 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8754/03.02/01/XI/2016 s/d 31-10-2021 333/SIPP/VIII/2017 s/d 31-10-2021

14 Salviyah Eka Nur Indriyani, S.Kep.Ners P Lamongan, 17 maret 1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10874/03.02/01/X/2015 s/d 17-03-2020 275/SIPP/VII/2017 s/d 17-03-2020
15 Nafa Ulya, A.Md.Kep P Lamongan, 3 juni 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8881/03.02/01/XII/2016 s/d 03-06-2021 331/SIPP/VIII/2017 s/d 03-06-2021
16 Guntoro Saikudin, A.Md.Kep L Lamongan, 23 februari 1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10500/03.02/02/X/2015 s/d 23-02-2020 519/SIPP/IX//2017 s/d 23-02-2020

17 Budi Setyo Utomo, S.Kep.Ners L Lamongan, 28 nopember Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2143/03.02/01/II/2015 s/d 28/11/2020 272/SIPP/VII/2017 s/d 28/11/2020
1990
18 Imam Sulistyono D.P, A.Md.Kep L Nganjuk, 15 sepetemer D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/7821/03.02/02/IX/2017 s/d 15-09-2022 517/SIPP/IX/2017 s/d 15-09-2022
1990
19 Lilis Ekawati, S.Kep.Ners P Lamongan, 08-04-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 P2T/271/03.02/01/I/2014 s/d 08-04-2019 33/SIK.P/I/2014 s/d 08-04-2019
20 Ari Isroh Eka Rahayu, A.Md.Kep P Lamongan, 27/03/1987 D3 Keperawatan PERAWAT Perawat Mahir PNS 01/01/2011 P2T/790/03.02/02/II/2019 s/d 27-03-2024 537/SIPP.1/413.111/III/2019.P1 s/d 27-03-2024
21 isvantri, A.Md.Kep L Lamongan, 07/10/1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 5 1 1 16-1201503 s/d 07/10/2021 2384/SIPP.I/413.111/VII/2018 s/d 07/10/2021
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG BOUGENVILE & DAHLIA 3
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Hidayatul Khoiroh, S.Kep.Ners P Gresik, 11/07/1967 Ners / 2011 PERAWAT Perawat Madya PNS 01-03-1990 P2T/4296/03.02/02/V/2017 s/d 11-07-2022 790/SIPP.I/413.111/III/2018 s/d 11-07-2022
2 Anita Yusi Safitri, A.Md.Kep P Lamongan, 11/09/1978 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/1651/03.02/01/II/2017 s/d 11/09/2022 96/SIPP/III/2017 s/d 11/09/2022
3 Dwi Nur Mahmudah, A.Md.Kep P Lamongan, 08/03/1982 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/01/2007 P2T/1659/03.02/01/II/2017 s/d 08/03/2022 97/SIPP/III/2017 s/d 08/03/2022
4 Heny Damayanti, S.Kep.Ners P Lamongan, 21/03/1987 Ners / 2011 PERAWAT Perawat Muda PNS 01-01-2011 P2T/6360/03.02/02/IX/2016 s/d 21/03/2021 388/SIPP/XI/2016 s/d 21/03/2021
5 Jefry Mahardika, S.Kep.Ns L Lamongan, 01-06-1990 Ners / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/5607/03.02/01/IV/2014 s/d 01/06/2019 285/SIPP/VII/2017 s/d 01/06/2019
6 Mariatus Solikhah, A.Md.Kep P Lamongan, 10-07-1982 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2009 P2T/5350/03.02/02/IV/2015 s/d 01/07/2020 205/SIPP/VI/2016 s/d 01/07/2020
7 Munzaeni, S.Kep.Ners L Lamongan, 07/05/1974 Ners / PERAWAT Perawat Muda PNS 01-03-1996 P2T/1875/03.02/02/IV/2019 s/d 07/05/2024 1989/SIPP.I/413.111/VII/2019.P1 s/d 07/05/2024

8 Siti Sukayah, A.Md.Kep P Lamongan, 30/01/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/1303/03.02/02/I/2017 s/d 30-01-2022 721/SIPP/VIII/2017 s/d 30-01-2022
9 Suharsono, A.Md.Kep L Lamongan, 07/12/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/9274/03.02/02/XI/2017 s/d 07/12/2022 950/SIPP.I/413.111/III/2018.P1 s/d 07/12/2022
10 Uswatun Hasanah, A.Md.Kep P Lamongan, 10-10-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/5112/03.02/02/X/2018 s/d 10/10/2023 3660/SIPP.P/413.111/XI/2018.P1 s/d 10/10/2023

11 Dewi Damayanti, A.Md.Kep P Lamongan, 30/03/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/741/03.02/02/II/2019 s/d 30/03/2024 469/SIPP.I/413.111/III/2019.P1 s/d 30/03/2024
12 Nunun Tilawati Setyo Fama, S.Kep.Ners P Lamongan, 30 maret 1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8394/03.02/01/XI/2016 s/d 30-03-2021 287/SIPP/VIII/2017 s/d 30-03-2021
13 Solifuddin, A.Md.Kep L Lamongan, 28-02-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3976/03.02/01/VI/2016 s/d 28-02-2021 442/SIPP/VIII/2017 s/d 28-02-2021
14 Khoirul Zainuddin Nasution, A.Md.Kep L Lamongan, 25 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/802/03.02/02/II/2010 s/d 25-12-2024 1990/SIPP.I/413.111/VII/2019 s/d 25-12-2024
1988
15 Afif Fajar Muhammadi, S.Kep.Ners L Lamongan, 10 oktober 1987 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/249/03.02/01/I/2014 s/d 10-10-2019 282/SIPP/VII/2017 s/d 10-10-2019

16 Ika Syahtia Hidayati, S.Kep.Ners P Lamongan, 26 juni 1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 16 01 7 2 1 18-2305882 s/d 26-06-2023 3641/SIPP.P/413.111/X/2018.P1 s/d 26-06-2023
17 Maslahatul Hidayah, A.Md.Kep P Lamongan, 31 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8911/03.02/01/XII/2016 s/d 31-12-2021 284/SIPP/VII/2017 s/d 31-12-2021
1994
18 Nursahril Likarevil, A.Md.Kep P lamongan, 7 oktober 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 1601521 18-2222323 s/d 07-10-2023 327/SIPP/VIII/2017 s/d 07-10-2023
19 Abdi Harianto, A.Md.Kep L Lamongan, 08/11/1986 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/8917/03.02/02/X/2017 s/d 07/11/2022 620/SIPP/XI/2017 s/d 07/11/2022
20 Intan Pratiwi, A.Md.Kep P Lamongan, 19/01/1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/8745/03.02/01/XI/2016 s/d 19/01/2021 2371/SIPP.I/413.111/VII/2018 s/d 19/01/2021
21 Ryandeaz Candraw, A.Md.Kep L Lamongan, 25/05/1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 5 1 1 16-1179436 s/d 25/05/2021 2592/SIPP.I/413.111/VII/2018 s/d 25/05/2021
22 Dwi Vita Febriyanti, S.Kep.Ners P Lamongan,13-02-1989 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 160172116-1117134 s/d 13/02/2021 1822/SIPP.I/413.111/VI/2019 s/d 13/02/2021
23 Lutfi Arfandia, A.Md.Kep L Lamongan, 23-11-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 1/11/2014 P2T/5794/03.02/02/XII/2018 s/d 23/11/2023 s/d 23/11/2023
24 Mujiono s/d 23/11/2024
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG BOUGENVILE 1 & 2
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Sucipto, S.Kep, Ns L Lamongan, 04/09/1970 Ners / 2012 PERAWAT Perawat Muda PNS 01-06-2002 P2T/4221/03.02/02/IX/2018 s/d 04/09/2023 3642/SIPP.I/413.111/X/2018.P1 s/d 04/09/2023
2 Eli Fitriani, A.Md.Kep P Lamongan, 02/06/1979 Ners / 2011 PERAWAT Perawat Muda PNS 01-12-2003 P2T/5421/03.02/VIII/2016 s/d 02-06-2021 434/SIPP/XI/2016 s/d 02-06-2021
3 Dwi Didik Kurniawan, A.Md.Kep L Lamongan, 26/12/1980 Ners / 2012 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/2515/03.02/01/III/2015 s/d 26/12/2020 260/SIK.P/VII/2014 s/d 26/12/2020
4 Wisnu Widi Atmanto, A.Md.Kep L Lamongan, 17-12-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/7492/03.02/01/IX/2013 s/d 17/12/2018 s/d 17/12/2018
5 Eko Hany Nur Rohman, A.Md.Kep L Lamongan, 25-04-1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2012 P2T/7022/03.02/02/X/2016 s/d 25/04/2021 295/SIPP/VII/2017 s/d 25/04/2021
6 Ilham Fatkul Karim, A.Md.Kep L Lamongan, 13-04-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/2394/03.02/02/III/2018 s/d 13/04/2023 3661/SIPP.I/413.111/XI/2018.P1 s/d 13/04/2023
7 Lina Anisatul, A.Md.Kep P Lamongan, 05-07-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/4321/03.02/02/V/2017 s/d 05/07/2022 463/SIPP/IX/2017 s/d 05/07/2022
8 Malisa Lutika Mega P, A.Md.Kep P Lamongan, 09-07-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/6342/03.02/02/VII/2017 s/d 09-07-2022 439/SIPP/VIII/2017 s/d 09-07-2022
9 Nina Puspita, A.Md.Kep P Lamongan, 06-07-1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2007 P2T/7718/03.02/02/XI/2016 s/d 06-07-2021 558/SIPP/XII/2016 s/d 06-07-2021
10 Septika Dyan Anggraeni, A.Md.Kep P Lamongan, 19-03-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2013 P2T/2692/03.02/02/III/2017 s/d 19/03/2022 588/SIPP/XI/2017 s/d 19/03/2022
11 Linda Wulansari, A.Md.Kep P Lamongan, 25 juli 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11642/03.02/01/XI/2015 s/d 25-07-2020 538/SIPP/X/2017 s/d 25-07-2020
12 Edi Sumono, A.Md.Kep L Lamongan, 10/03/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/1558/03.02/02/I/2017 s/d 10-03-2022 610/SIPP/XI/2017 s/d 10-03-2022
13 Zakka Yudha Pratama, A.Md.Kep L Lamongan, 02-03-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2013 P2T/1968/03.02/02/II/2017 s/d 02-03-2022 726/SIPP/VIII/2017 s/d 02-03-2022
14 Ulmarofah, A.Md.Kep P Lamongan, 07 -07-1983 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 02/01/2008 P2T/683/03.02/02/I/2016 s/d 07-07-2021 195/SIPP/VI/2016 s/d 07-07-2021
15 Satria Budi Pramana, A.Md.Kep L Lamongan, 4 juli 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11614/03.02/01/XI/2015 s/d 04-07-2020 449/SIPP/IX/2017 s/d 04-07-2020
16 Solfiyatul Fitriyah, A.Md.Kep P Lamongan, 06-03-1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/9104/03.02/01/XII/2016 s/d 06-03-2021 440/SIPP/VIII/2017 s/d 06-03-2021
17 Fitri Rosyidah, S.Kep.Ners P gresik, 29 msret 1987 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2982/03.02/02/III/2017 s/d 29-03-2022 293/SIPP/VII/2017 s/d 29-03-2022
18 Lilis Suryaningsih, A.Md.Kep P Lamongan, 24 maret 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8742/03.02/01/XI/2016 s/d 24-03-2021 394/SIPP/VII/2017 s/d 24-03-2021
19 Diniatul Amaliyah, A.Md.Kep P Lamongan, 24-05-1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8801/03.02/01/XI/2016 s/d 24/05/2021 441/SIPP/VIII/2017 s/d 24/05/2021
20 Poniti Dwi Lestari, A.Md.Kep P Lamongan, 3 juni 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 1/5/2017 P2T/8753/03.02/01/XI/2016 s/d 03-06-2021 292/SIPP/VII/2017 s/d 03-06-2021
21 Nurul Islami, A.Md.Kep P Lamongan 2 desember 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8774/03.02/01/XI/2016 s/d 02/12/2021 300/SIPP/VII/2017 s/d 02/12/2021

22 Ina Argayanti, S.Kep.Ners P Lamongan, 07/03/1988 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/2744/03.02/02/III/2017 s/d 07/03/2022 2715/SIPP.1/413.111/VII/2018 s/d 07/03/2022
23 Viva Ronica Puspita Handayani, A.Md.Kep P Lamongan, 07/01/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/1449/03.02/01/II/2018 s/d 07/01/2021 2253/SIPP.I/413.111/VIII/2019 s/d 07/01/2021
24 Titin Hardiyanti, A.Md.Kep P Lamongan, 12/05/1997 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/120/03.02/01/I/2019 s/d 12/05/2024 2255/SIPP.I/413.111/VIII/2019 s/d 12/05/2024
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG KEMUNING
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Suyono, S.Kep., Ns L Lamongan, 17/08/1968 Ners / 2011 PERAWAT Perawat Madya PNS 01-03-1989 P2T/6768/03.02/02/VII/2017 s/d 17-08-2022 326/SIPP/VIII/2017 s/d 17-08-2022
2 Choliq Tri Widodo, A.Md.Kep L Lamongan, 15 -07-1982 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/7246/03.02/02/X/2016 s/d 15-07-2021 703/SIPP/XII/2017 s/d 15-07-2021
3 Eka Putri Senjawati, S.Kep.Ns P Lamongan, 30-11-1988 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 16 01 7 2 1 18-2305912 s/d 30/11/2023 3491/SIPP.I/413.111/X/2018.P1 s/d 30/11/2023
4 Fajar Arianti Nur C, A.Md.Kep P Lamongan, 25-07-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/7501/03.02/01/IX/2014 s/d 25-07-2019 213/SIPP/VII/2016 s/d 25-07-2019
5 Joko Purwanto, S.Kep.Ners L Sumenep, 16/04/1975 Ners / 2012 PERAWAT Perawat Muda PNS 01-12-2000 P2T/1081/03.02/02/III/2019 s/d 16/04/2024 216/SIPP/VII/2016 s/d 16/04/2024
6 Sudarwati, A.Md.Kep P 3524226211760004 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/10209/03.02/01/X/2015 s/d 22-11-2020 220/SIPP/VII/2016 s/d 22-11-2020
7 Sunyoto, A.Md.Kep L Lamongan, 17-12-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 P2T/8918/03.02/02/X/2017 s/d 17/12/2022 704/SIPP/XII/2017 s/d 17/12/2022
8 Chilyatus Sa'adah, A.Md.Kep P Lamongan, 03/12/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 02/09/2009 160152118-2404838 s/d 03/12/2023 2302/SIPP.I/413.111/IX/2019.P1 s/d 03/12/2023
9 Wahyu Ismayati, A.Md.Kep P Lamongan, 16 -08- 1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2009 16 01 5 2 1 18-2306183 s/d 16/08/2023 3493/SIPP.I/413.111/X/2018.P1 s/d 16/08/2023
10 Nur Kholidah, A.Md.Kep P Lamongan, 09/08/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/450/03.02/02/I/2016 s/d 09/08/2021 15/SIPP/I/2016 s/d 09/08/2021
11 Siti Fatimah, A.Md.Kep P Mojokerto, 17/04/1978 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/01/2010 16 01 5 2 1 18-2306186 s/d 17-04-2023 3478/SIPP.I/413.111/X/2018.P1 s/d 17-04-2023
12 Saifuddin Hasan, A.Md.Kep L Lamongan, 2 mei 1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3814/03.02/02/IV/2017 s/d 02-05-2022 462/SIPP/IX/2017 s/d 02-05-2022
13 Anggi Dwi Krisdiyanto, A.Md.Kep L Lamongan, 26-06-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/7661/03.02/01/IX/2014 s/d 26/06/2019 601/SIPP/XI/2017 s/d 26/06/2019
14 El Maya Audria, A.Md.Kep P Lamongan, 13 maret 1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8929/03.02/01/XII/2016 s/d 13-03-2021 323/SIPP/VIII/2017 s/d 13-03-2021
15 Finna Dwi Ningtyas, S.Kep.Ners P Lamongan, 30Juni 1991 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2254/03.02/01/III/2015 s/d 30-06-2020 273/SIPP/VII/2017 s/d 30-06-2020
16 Devi Ayu Puspitaning Tyas, A.Md.Kep P lamongan, 12 oktober 1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 16 01 5 2 1 18-2306187 s/d 12/10/2023 3490/SIPP.S/413.111/X/2018.P1 s/d 12/10/2023
17 Zeni Evit Nurvia, A.Md.Kep P lamongan, 3 April 1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11647/03.02/01/XI/2015 s/d 03-05-2020 494/SIPP/XI/2017 s/d 03-05-2020
18 M. Firman Haqiqi, A.Md.Kep L Lamongan, 7 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2527/03.02/01/II/2014 s/d 07-12-2019 389/SIPP/VIII/2017 s/d 07-12-2019
1990
19 M. Zaenul Arifin, S.Kep.Ners L Lamongan, 19 mei 1988 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 16 01 7 1 1 18-2305881 s/d 19/05/2023 299/SIPP/VII/2017 s/d 19/05/2023
20 Lailatun Nadhiroh, A.Md.Kep P Lamongan, 20 maret 1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152118-2390315 s/d 20-03-2023 2300/SIPP.I/413.111/IX/2019.P1 s/d 20-03-2023
21 Fahmi Syarifuddin, S.Kep.Ners L Lamongan, 19/10/1994 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/7652/03.02/01/IX/2017 s/d 19/10/2022 2385/SIPP.I/413.111/VII/2018 s/d 19/10/2022
22 Erlita Puspitasari, A.Md.Kep P Lamongan, 20/07/1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/8740/03.02/01/XI/2016 s/d 20/07/2021 2368/SIPP.I/413.111/VII/2018 s/d 20/07/2021
23 Mia Dwi Wahyu Anggraeny, A.Md.Kep P Lamongan, 25-05-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/9982/03.02/01/XII/2017 s/d 25/05/2022 1774/SIPP.I/413.111/VI/2019 s/d 25/05/2022
24 Mar’atus Solikhah, A.Md.Kep P Lamongan, 1-10-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/11504/03.02/01/X/2015 s/d 01/10/2020 1830/SIPP.I/413.111/VI/2019 s/d 01/10/2020
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG DAHLIA 1 & 2
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK

1 2 3 4 5 6 7 8 9 10 11
1 Rochmah Purwati, S.Kep., Ns P Lamongan, 28/11/1967 Ners / 2011 PERAWAT Perawat Madya PNS 01/01/1988 P2T/8916/03.02/02/X/2017 s/d 28-11-2022 619/SIPP/XI/2017 s/d 28-11-2022
2 Sukardi, S.Kep.Ns L Lamongan, 04/05/1966 Ners / 2011 PERAWAT Perawat Madya PNS 01/03/1989 P2T/9074/03.02/02/XI/2017 s/d 04-05-2022 587/SIPP/XI/2017 s/d 04-05-2022
3 Ana Shofiyah, A.Md.Kep P Lamongan, 29-09-1983 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/7564/03.02/01/VII/2015 s/d 29-09-2020 211/SIPP/VI/2016 s/d 29-09-2020
4 Heny Kusrina, S.Kep.Ns P Lamongan, 20-02-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/747/03.02/02/I/2018 s/d 20/02/2023 04/SIPP.I/413.111/II/2018 s/d 20/02/2023
5 Ibrahim Marta Legawa, A.Md.Kep L Lamongan, 13-02-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/708/03.02/02/II/2019 s/d 13/02/2024 1881/SIPP.I/413.111/VII/2019.P1 s/d 13/02/2024
6 Ilung Ambar Kurniawan, A.Md.Kep L Malang, 24-03-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2013 P2T/1970/03.02/02/II/2017 s/d 24-03-2022 321/SIPP/VIII/2017 s/d 24-03-2022
7 Maghfiroh, A.Md.Kep P Pangkalan Bun, 07/02/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/764/03.02/02/I/2018 s/d 07/02/2023 07/SIPP.I/413.111/II/2018 s/d 07/02/2023
8 Rutin, A.Md.Kep P Lamongan, 21/02/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/4543/03.02/01/III/2015 s/d 21-02-2020 129/SIK.P/V/2015 s/d 21-02-2020
9 Stevia Febrinda Putri Eriyati, A.Md.Kep P Lamongan, 22-02-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 P2T/1290/03.02/02/I/2017 s/d 22/02/2022 267/SIPP/VII/2017 s/d 22/02/2022
10 Wawan Setiawan, A.Md.kep L Malang, 09-05-1977 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2012 P27/3980/03.02/02/V/2017 s/d 09/05/2022 720/SIPP/VIII/2017 s/d 09/05/2022
11 Angga Fridian Hari P. S.Kep.Ners L Lamongan, 13/01/1993 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/10740/03.02/01/X/2015 s/d 13/01/2020 2386/SIPP.I/413.111/VII/2018 s/d 13/01/2020
12 Vinni Alfia Nita Dewi, A.Md.Kep P Lamongan, 16-01-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/2570/03.02/02/IV/2018 s/d 16/01/2023 1564/SIPP.I/413.111/IV/2018 s/d 16/01/2023
13 Juliatin Dwi Lestanti, A.Md.Kep P Lamongan, 29-12-1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/497/03.02/02/I/2015 s/d 29-12-2020 322/SIPP/VIII/2017 s/d 29-12-2020
14 Yulinda Prastika Wardhani, A.Md.Kep P Gresik, 02-05-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11601/03.02/01/XI/2015 s/d 02-05-2020 823/SIPP/VIII/2017 s/d 02-05-2020
15 Marta Ika Pratiwi, A.Md.Kep P Lamongan, 17-03-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3997/03.02/02/VIII/2018 s/d 17-03-2023 3846/SIPP.I/4113.111/XI/2018.P1 s/d 17-03-2023
16 Sri Agustin, A.Md.Kep P Lamongan, 06/11/1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 5 2 1 17-2047289 s/d 06/11/2022 2593/SIPP.I/413.111/VII/2018 s/d 06/11/2022
17 Erni Widiastutik, A.Md.Kep P Lamongan, 10 maret 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8744/03.02/01/XI/2016 s/d 10-03-2021 394/SIPP/VIII/2017 s/d 10-03-2021
18 Erwinsyah Eko Nugroho, A.Md.Kep L Lamongan, 02-03-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2583/03.02/02/III/2017 s/d 02-03-2022 325/SIPP/VIII/2017 s/d 02-03-2022
19 Sutoyo, S.Kep.Ners L Lamongan, 28-6-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2388/03.02/02/VI/2019 s/d 28-06-2019 2113/SIPP.I/4113.111/VII/2019.P1 s/d 28-06-2019
20 Dwi Agus Milasari, A.Md.Kep P Lamongan, 25 agustus 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8795/03.02/01/XI/2016 s/d 25-08-2021 301/SIPP/VII/2017 s/d 25-08-2021

21 Nurmauli Diana, S.Kep.Ners P Lamongan, 12 september Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8396/03.02/01/XI/2016 s/d 12-09-2021 395/SIPP/VIII/2017 s/d 12-09-2021
1993
22 Agus Zaenal, S.Kep., Ns L Lamongan, 12/08/1969 Ners / 2013 PERAWAT Perawat Muda PNS 15/07/2010 P2T/2384/03.02/01/II/2017 s/d 12/08/2022 3483/SIPP.I/413.111/X/2018.P1 s/d 12/08/2022
23 Syahrizal Hakim, S.Kep.Ners L Lamongan, 12-02-1993 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8436/03.02/01/XI/2016 s/d 12/02/2021 1652/SIPP.I/413.111/V/2019 s/d 12/02/2021
24 Abdur Ruchman Sulichan, A.Md.Kep L Lamongan, 05/10/1990 D3 Keperawatan / PERAWAT Perawat Kontrak 01/04/2016 P2T/7826/03.02/02/IX/2017 s/d 05-10-2022 2057/SIPP.I/413.111/V/2018.P1 s/d 05-10-2022
Pemda
KETERANGAN

12
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG NEONATUS
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Nayem, S.Kep.Ners P Lamongan, 24/12/1967 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1991 160172115-0978079 s/d 24/12/2020 3643/SIPP.I/413.111/X/2018.P1 s/d 24/12/2020
2 Anis Dwi Kurniawati, S.Kep.Ners P Lamongan, 13/04/1980 Ners / 2016 PERAWAT Perawat Muda PNS 01/12/2003 P2T/1650/03.02/01/II/2017 s/d 13/04/2022 124/SIPP/III/2017 s/d 13/04/2022
3 Susi Nikmatul Jannah, A.Md.Keb
4 Aryunita Dian R, A.Md.Kep P Lamongan, 8 -04-1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2007 P2T/7994/03.02/02/XI/2016 s/d 08/04/2021 561/SIPP/XII/2016 s/d 08/04/2021
5 Irnawati, S.Kep.Ners P Lamongan, 16/10/1980 Ners / 2016 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/1652/03.02/01/II/2017 s/d 16/10/2022 125/SIPP/III/2017 s/d 16/10/2022
6 Minatul Maknuna, S.Kep. Ners P Gresik, 30/07/1974 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1998 16 01 7 2 1 15-0978078 s/d 30/07/2020 3148/SIPP.I/413.111/VIII/2018.P1 s/d 30/07/2020

7 Nikmatun Cahyani, A.Md.Kep P Lamongan, 18-05-1982 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2007 P2T/3759/03.02/02/IV/2017 s/d 18/05/2022 188/SIPP/V/2017 s/d 18/05/2022
8 Lailatul Aprilia, A.Md.Keb
9 Yuanita Kurniawati, A.Md.Keb
10 Surya Wira Pratiwi, A.Md.Keb
11 Uswatun Khasanah, A.Md.Keb
12 Rizky Wulandari, A.Md.Kep P bojonegoro, 7 september D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/4256/03.02/02/IX/2018 s/d 07-09-2023 3935/SIPP.I/413.111/XII/2018.P1 s/d 07-09-2023
1992
13 Fajar Pramita Ayu Meliyana, A.Md.Kep P Lamongan, 15-03-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/1434/03.02/02/III/2019 s/d 15-03-2024 2170/SIPP.I/413.111/VIII/2019.P1 s/d 15-03-2024

14 Ma’rifatul ‘Ain, A.Md.Kep P Lamongan, 25-10-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/511/03.02/02/II/2019 s/d 25-10-2024 450/SIPP/IX/2017 s/d 25-10-2024
15 Fibrita Damayanti, S.Kep.Ners P Lamongan, 01/02/1990 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/801/03.02/02/II/2019 s/d 01/02/2024 2109/SIPP.I/413.111/VII/2019.P1 s/d 01/02/2024

16 Nur Azizah, A.Md.Kep P Lamongan, 15/10/1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/9318/03.02/01/XII/2016 s/d 15/10/2021 2248/SIPP.I/413.111/VIII/2019 s/d 15/10/2021
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
RUANG ANGGREK
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Sumarlin, S.Kep., Ns P Lamongan, 29/06/1969 Ners / 2010 PERAWAT Perawat Muda PNS 01/03/1992 P2T/4316/03.02/02/V/2017 s/d 29/06/2022 194/SIPP/XI/2017 s/d 29/06/2022
2 Aini Zamrotul Mufidah, A.Md.Kep P Lamongan, 04-07-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/4152/03.02/02/VII/2018 s/d 04/07/2023 4043/SIPP.I/413.111/XII/2018.P1 s/d 04/07/2023

3 Kurniawati, A.Md.Kep P Lamongan, 15-04-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/2511/03.02/02/III/2017 s/d 15-04-2022 193/SIPP/V/2017 s/d 15-04-2022
4 Mazidah Mahargiani, A.Md.Kep P Lamongan, 14/11/1985 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/1331/03.02/02/XI/2015 s/d 14/11/2020 85/SIPP/III/2017 s/d 14/11/2020
5 Novita Rochmawati, A.Md.Kep P Blitar, 07 -11-1986 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/9068/03.02/02/XI/2017 s/d 07/11/2022 622/SIPP/XI/2017 s/d 07/11/2022
6 Sita Nur Jannah, S.Kep.Ns P Lamongan, 16-05-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/3175/03.02/02/V/2018 s/d 16/05/2023 4040/SIPP.I/413.111/XII/2018.P1 s/d 16/05/2023

7 Sri Purwati, A.Md.Kep P Lamongan, 28 -02-1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/1577/03.02/02/I/2017 s/d 28/02/2022 86/SIPP/III/2017 s/d 28/02/2022
8 Nur Sholikah, S.Kep.Ners P Lamongan, 1 april 1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2477/03.02/01/III/2015 s/d 01-04-2020 268/SIPP/VII/2017 s/d 01-04-2020
9 Arinindya Purwa Hananda Putri, A.Md.Kep P Lamongan, 18 januari 1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152119-2415086 s/d 18-01-2024 2251/SIPP.I/413.111/VIII/2019 s/d 18-01-2024
10 Pratiwi Manandya Rahmanu K, A.Md.Kep
11 Novemi Anadiyati, S.Kep.Ners P Lamongan, 11 nopember Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/428/03.02/01/I/2014 s/d 11-11-2019 385/SIPP/VIII/2017 s/d 11-11-2019
1990
12 Susi Robiatus Saniyah, A.Md.Kep P Lamongan, 26 mei 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11677/03.02/01/XI/2015 s/d 26-05-2020 412/SIPP/VIII/2017 s/d 26-05-2020
5 Feti Rahayu Indriyatiningsih, S.Kep Ns P Lamongan, 16/01/1982 Ners / 2013 PERAWAT Perawat Pertama PNS 01/01/2007 P2T/231/03.02/02/I/2019 s/d 16-01-2024 325/SIPP.I/413.111/II/2019.P1 s/d 16-01-2024
14 Tri Winda Sulistyowati, S.Kep.Ners P Lamongan, 14/03/1991 Ners / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/7822/03.02/01/VII/2015 s/d 14/03/2020 2372/SIPP.I/413.111/VII/2018 s/d 14/03/2020
15 Dina Hidayatul Aminah, A.Md.Kep
16 Ummu Khabibah, S.Kep.Ners
17 Kefi Afiyah, A.Md.Kep
DATA PERSONIL TENAGA KEPERAWATAN
RUMAH SAKIT UMUM DAERAH Dr. SOEGIRI LAMONGAN
JENIS TEMPAT DAN TANGGAL STATUS
NO NAMA KELAMIN LAHIR PENDIDIKAN TERAKHIR PEKERJAAN JABATAN TENAGA DIANGKAT TMT STR SIP/ SIK KETERANGAN

1 2 3 4 5 6 7 8 9 10 11 12
1 Sumarlin, S.Kep., Ns P Lamongan, 29/06/1969 Ners / 2010 PERAWAT Perawat Muda PNS 01/03/1992 P2T/4316/03.02/02/V/2017 s/d 29/06/2022 194/SIPP/XI/2017 s/d 29/06/2022
2 Aini Zamrotul Mufidah, A.Md.Kep P Lamongan, 04-07-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/4152/03.02/02/VII/2018 s/d 04/07/2023 4043/SIPP.I/413.111/XII/2018.P1 s/d 04/07/2023

3 Kurniawati, A.Md.Kep P Lamongan, 15-04-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/2511/03.02/02/III/2017 s/d 15-04-2022 193/SIPP/V/2017 s/d 15-04-2022
4 Mazidah Mahargiani, A.Md.Kep P Lamongan, 14/11/1985 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/1331/03.02/02/XI/2015 s/d 14/11/2020 85/SIPP/III/2017 s/d 14/11/2020
5 Nellis Verlinalasa, A.Md.Kep P Tuban, 20/01/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/3441/03.02/02/VII/2018 s/d 20/01/2023 326/SIPP.I/413.111/II/2019.P1 s/d 20/01/2023
6 Novita Rochmawati, A.Md.Kep P Blitar, 07 -11-1986 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/9068/03.02/02/XI/2017 s/d 07/11/2022 622/SIPP/XI/2017 s/d 07/11/2022
7 Sita Nur Jannah, S.Kep.Ns P Lamongan, 16-05-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/3175/03.02/02/V/2018 s/d 16/05/2023 4040/SIPP.I/413.111/XII/2018.P1 s/d 16/05/2023

8 Sri Purwati, A.Md.Kep P Lamongan, 28 -02-1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/1577/03.02/02/I/2017 s/d 28/02/2022 86/SIPP/III/2017 s/d 28/02/2022
9 Zunti Masruroh, S.Kep.Ners P Lamongan, 25/02/1975 Ners / 2014 PERAWAT Perawat Muda PNS 01-12-2000 P2T/6994/03.02/01/VI/2015 s/d 25/02/2020 222/SIPP/VII/2016 s/d 25/02/2020
10 Nur Sholikah, S.Kep.Ners P Lamongan, 1 april 1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2477/03.02/01/III/2015 s/d 01-04-2020 268/SIPP/VII/2017 s/d 01-04-2020
11 Arinindya Purwa Hananda Putri, A.Md.Kep P Lamongan, 18 januari 1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152119-2415086 s/d 18-01-2024 2251/SIPP.I/413.111/VIII/2019 s/d 18-01-2024
12 Novemi Anadiyati, S.Kep.Ners P Lamongan, 11 nopember Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/428/03.02/01/I/2014 s/d 11-11-2019 385/SIPP/VIII/2017 s/d 11-11-2019
1990
13 Susi Robiatus Saniyah, A.Md.Kep P Lamongan, 26 mei 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11677/03.02/01/XI/2015 s/d 26-05-2020 412/SIPP/VIII/2017 s/d 26-05-2020
14 Tri Winda Sulistyowati, S.Kep.Ners P Lamongan, 14/03/1991 Ners / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/7822/03.02/01/VII/2015 s/d 14/03/2020 2372/SIPP.I/413.111/VII/2018 s/d 14/03/2020
15 Nayem, S.Kep.Ners P Lamongan, 24/12/1967 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1991 160172115-0978079 s/d 24/12/2020 3643/SIPP.I/413.111/X/2018.P1 s/d 24/12/2020
16 Anis Dwi Kurniawati, S.Kep.Ners P Lamongan, 13/04/1980 Ners / 2016 PERAWAT Perawat Muda PNS 01/12/2003 P2T/1650/03.02/01/II/2017 s/d 13/04/2022 124/SIPP/III/2017 s/d 13/04/2022
17 Aryunita Dian R, A.Md.Kep P Lamongan, 8 -04-1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2007 P2T/7994/03.02/02/XI/2016 s/d 08/04/2021 561/SIPP/XII/2016 s/d 08/04/2021
18 Irnawati, S.Kep.Ners P Lamongan, 16/10/1980 Ners / 2016 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/1652/03.02/01/II/2017 s/d 16/10/2022 125/SIPP/III/2017 s/d 16/10/2022
19 Minatul Maknuna, S.Kep. Ners P Gresik, 30/07/1974 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1998 16 01 7 2 1 15-0978078 s/d 30/07/2020 3148/SIPP.I/413.111/VIII/2018.P1 s/d 30/07/2020

20 Nikmatun Cahyani, A.Md.Kep P Lamongan, 18-05-1982 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2007 P2T/3759/03.02/02/IV/2017 s/d 18/05/2022 188/SIPP/V/2017 s/d 18/05/2022
21 Rizky Wulandari, A.Md.Kep P bojonegoro, 7 september D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/4256/03.02/02/IX/2018 s/d 07-09-2023 3935/SIPP.I/413.111/XII/2018.P1 s/d 07-09-2023
1992
22 Fajar Pramita Ayu Meliyana, A.Md.Kep P Lamongan, 15-03-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/1434/03.02/02/III/2019 s/d 15-03-2024 2170/SIPP.I/413.111/VIII/2019.P1 s/d 15-03-2024

23 Ma’rifatul ‘Ain, A.Md.Kep P Lamongan, 25-10-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/511/03.02/02/II/2019 s/d 25-10-2024 450/SIPP/IX/2017 s/d 25-10-2024
24 Fibrita Damayanti, S.Kep.Ners P Lamongan, 01/02/1990 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/801/03.02/02/II/2019 s/d 01/02/2024 2109/SIPP.I/413.111/VII/2019.P1 s/d 01/02/2024

25 Rochmah Purwati, S.Kep., Ns P Lamongan, 28/11/1967 Ners / 2011 PERAWAT Perawat Madya PNS 01/01/1988 P2T/8916/03.02/02/X/2017 s/d 28-11-2022 619/SIPP/XI/2017 s/d 28-11-2022
26 Addy Budi Purwanto, S.Kep.Ners L Lamongan, 18/12/1989 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/195/03.02/02/I/2015 s/d 18/12/2020 256/SIK.P/VIII/2015 s/d 18/12/2020
27 Ana Shofiyah, A.Md.Kep P Lamongan, 29-09-1983 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/7564/03.02/01/VII/2015 s/d 29-09-2020 211/SIPP/VI/2016 s/d 29-09-2020
28 Heny Kusrina, S.Kep.Ns P Lamongan, 20-02-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/747/03.02/02/I/2018 s/d 20/02/2023 04/SIPP.I/413.111/II/2018 s/d 20/02/2023
29 Ibrahim Marta Legawa, A.Md.Kep L Lamongan, 13-02-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/708/03.02/02/II/2019 s/d 13/02/2024 1881/SIPP.I/413.111/VII/2019.P1 s/d 13/02/2024

30 Ilung Ambar Kurniawan, A.Md.Kep L Malang, 24-03-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2013 P2T/1970/03.02/02/II/2017 s/d 24-03-2022 321/SIPP/VIII/2017 s/d 24-03-2022
31 Kartono, SST L Lamongan, 21/12/1968 D4 Keperawatan Medikal PERAWAT Perawat Muda PNS 01-03-1995 P2T/5520/03.02/02/X/2018 s/d 21/12/2023 4106/SIPP.I/413.111/XII/2018.P1 s/d 21/12/2023
Bedah / 2012
32 Maghfiroh, A.Md.Kep P Pangkalan Bun, 07/02/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/764/03.02/02/I/2018 s/d 07/02/2023 07/SIPP.I/413.111/II/2018 s/d 07/02/2023

33 Rutin, A.Md.Kep P Lamongan, 21/02/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/4543/03.02/01/III/2015 s/d 21-02-2020 129/SIK.P/V/2015 s/d 21-02-2020
34 Sukardi, S.Kep.Ns L Lamongan, 04/05/1966 Ners / 2011 PERAWAT Perawat Madya PNS 01/03/1989 P2T/9074/03.02/02/XI/2017 s/d 04-05-2022 587/SIPP/XI/2017 s/d 04-05-2022
35 Wawan Setiawan, A.Md.kep L Malang, 09-05-1977 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2012 P27/3980/03.02/02/V/2017 s/d 09/05/2022 720/SIPP/VIII/2017 s/d 09/05/2022
36 Stevia Febrinda Putri Eriyati, A.Md.Kep P Lamongan, 22-02-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 P2T/1290/03.02/02/I/2017 s/d 22/02/2022 267/SIPP/VII/2017 s/d 22/02/2022
37 Vinni Alfia Nita Dewi, A.Md.Kep P Lamongan, 16-01-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/2570/03.02/02/IV/2018 s/d 16/01/2023 1564/SIPP.I/413.111/IV/2018 s/d 16/01/2023
38 Juliatin Dwi Lestanti, A.Md.Kep P Lamongan, 29-12-1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/497/03.02/02/I/2015 s/d 29-12-2020 322/SIPP/VIII/2017 s/d 29-12-2020
39 Yulinda Prastika Wardhani, A.Md.Kep P Gresik, 02-05-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11601/03.02/01/XI/2015 s/d 02-05-2020 823/SIPP/VIII/2017 s/d 02-05-2020
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
40 Marta Ika Pratiwi, A.Md.Kep P Lamongan, 17-03-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3997/03.02/02/VIII/2018 s/d 17-03-2023 3846/SIPP.I/4113.111/XI/2018.P1 s/d 17-03-2023

41 Lutfi Arfandia, A.Md.Kep L Lamongan, 23-11-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 1/11/2014 P2T/5794/03.02/02/XII/2018 s/d 23/11/2023 s/d 23/11/2023
42 Erni Widiastutik, A.Md.Kep P Lamongan, 10 maret 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8744/03.02/01/XI/2016 s/d 10-03-2021 394/SIPP/VIII/2017 s/d 10-03-2021
43 Erwinsyah Eko Nugroho, A.Md.Kep L Lamongan, 02-03-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2583/03.02/02/III/2017 s/d 02-03-2022 325/SIPP/VIII/2017 s/d 02-03-2022
44 Sutoyo, S.Kep.Ners L Lamongan, 28-6-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2388/03.02/02/VI/2019 s/d 28-06-2019 2113/SIPP.I/4113.111/VII/2019.P1 s/d 28-06-2019

45 Dwi Agus Milasari, A.Md.Kep P Lamongan, 25 agustus 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8795/03.02/01/XI/2016 s/d 25-08-2021 301/SIPP/VII/2017 s/d 25-08-2021

46 Nurmauli Diana, S.Kep.Ners P Lamongan, 12 september Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8396/03.02/01/XI/2016 s/d 12-09-2021 395/SIPP/VIII/2017 s/d 12-09-2021
1993
47 Sri Agustin, A.Md.Kep P Lamongan, 06/11/1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 5 2 1 17-2047289 s/d 06/11/2022 2593/SIPP.I/413.111/VII/2018 s/d 06/11/2022
48 Angga Fridian Hari P. S.Kep.Ners L Lamongan, 13/01/1993 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/10740/03.02/01/X/2015 s/d 13/01/2020 2386/SIPP.I/413.111/VII/2018 s/d 13/01/2020
49 Suyono, S.Kep., Ns L Lamongan, 17/08/1968 Ners / 2011 PERAWAT Perawat Madya PNS 01-03-1989 P2T/6768/03.02/02/VII/2017 s/d 17-08-2022 326/SIPP/VIII/2017 s/d 17-08-2022
50 Choliq Tri Widodo, A.Md.Kep L Lamongan, 15 -07-1982 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/7246/03.02/02/X/2016 s/d 15-07-2021 703/SIPP/XII/2017 s/d 15-07-2021
51 Eka Putri Senjawati, S.Kep.Ns P Lamongan, 30-11-1988 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 16 01 7 2 1 18-2305912 s/d 30/11/2023 3491/SIPP.I/413.111/X/2018.P1 s/d 30/11/2023
52 Fajar Arianti Nur C, A.Md.Kep P Lamongan, 25-07-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/7501/03.02/01/IX/2014 s/d 25-07-2019 213/SIPP/VII/2016 s/d 25-07-2019
53 Joko Purwanto, S.Kep.Ners L Sumenep, 16/04/1975 Ners / 2012 PERAWAT Perawat Muda PNS 01-12-2000 P2T/1081/03.02/02/III/2019 s/d 16/04/2024 216/SIPP/VII/2016 s/d 16/04/2024
54 Sudarwati, A.Md.Kep P 3524226211760004 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/10209/03.02/01/X/2015 s/d 22-11-2020 220/SIPP/VII/2016 s/d 22-11-2020
55 Sunyoto, A.Md.Kep L Lamongan, 17-12-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 P2T/8918/03.02/02/X/2017 s/d 17/12/2022 704/SIPP/XII/2017 s/d 17/12/2022
56 Chilyatus Sa'adah, A.Md.Kep P Lamongan, 03/12/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 02/09/2009 160152118-2404838 s/d 03/12/2023 2302/SIPP.I/413.111/IX/2019.P1 s/d 03/12/2023
57 Wahyu Ismayati, A.Md.Kep P Lamongan, 16 -08- 1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2009 16 01 5 2 1 18-2306183 s/d 16/08/2023 3493/SIPP.I/413.111/X/2018.P1 s/d 16/08/2023
58 Nur Kholidah, A.Md.Kep P Lamongan, 09/08/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/450/03.02/02/I/2016 s/d 09/08/2021 15/SIPP/I/2016 s/d 09/08/2021
59 Siti Fatimah, A.Md.Kep P Mojokerto, 17/04/1978 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/01/2010 16 01 5 2 1 18-2306186 s/d 17-04-2023 3478/SIPP.I/413.111/X/2018.P1 s/d 17-04-2023
60 Saifuddin Hasan, A.Md.Kep L Lamongan, 2 mei 1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3814/03.02/02/IV/2017 s/d 02-05-2022 462/SIPP/IX/2017 s/d 02-05-2022
61 Anggi Dwi Krisdiyanto, A.Md.Kep L Lamongan, 26-06-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/7661/03.02/01/IX/2014 s/d 26/06/2019 601/SIPP/XI/2017 s/d 26/06/2019
62 El Maya Audria, A.Md.Kep P Lamongan, 13 maret 1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8929/03.02/01/XII/2016 s/d 13-03-2021 323/SIPP/VIII/2017 s/d 13-03-2021
63 Finna Dwi Ningtyas, S.Kep.Ners P Lamongan, 30Juni 1991 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2254/03.02/01/III/2015 s/d 30-06-2020 273/SIPP/VII/2017 s/d 30-06-2020
64 Devi Ayu Puspitaning Tyas, A.Md.Kep P lamongan, 12 oktober 1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 16 01 5 2 1 18-2306187 s/d 12/10/2023 3490/SIPP.S/413.111/X/2018.P1 s/d 12/10/2023
65 Zeni Evit Nurvia, A.Md.Kep P lamongan, 3 April 1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11647/03.02/01/XI/2015 s/d 03-05-2020 494/SIPP/XI/2017 s/d 03-05-2020
66 M. Firman Haqiqi, A.Md.Kep L Lamongan, 7 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2527/03.02/01/II/2014 s/d 07-12-2019 389/SIPP/VIII/2017 s/d 07-12-2019
1990
67 M. Zaenul Arifin, S.Kep.Ners L Lamongan, 19 mei 1988 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 16 01 7 1 1 18-2305881 s/d 19/05/2023 299/SIPP/VII/2017 s/d 19/05/2023
68 Lailatun Nadhiroh, A.Md.Kep P Lamongan, 20 maret 1987 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152118-2390315 s/d 20-03-2023 2300/SIPP.I/413.111/IX/2019.P1 s/d 20-03-2023
69 Fahmi Syarifuddin, S.Kep.Ners L Lamongan, 19/10/1994 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/7652/03.02/01/IX/2017 s/d 19/10/2022 2385/SIPP.I/413.111/VII/2018 s/d 19/10/2022
70 Erlita Puspitasari, A.Md.Kep P Lamongan, 20/07/1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/8740/03.02/01/XI/2016 s/d 20/07/2021 2368/SIPP.I/413.111/VII/2018 s/d 20/07/2021
71 Nur Aminuddin, A.Md.Kep L Lamongan, 12/05/1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/6915/03.02/02/VIII/2017 s/d 12/05/2022 2381/SIPP.I/413.111/VII/2018 s/d 12/05/2022
72 Sucipto, S.Kep, Ns L Lamongan, 04/09/1970 Ners / 2012 PERAWAT Perawat Muda PNS 01-06-2002 P2T/4221/03.02/02/IX/2018 s/d 04/09/2023 3642/SIPP.I/413.111/X/2018.P1 s/d 04/09/2023
73 Eli Fitriani, A.Md.Kep P Lamongan, 02/06/1979 Ners / 2011 PERAWAT Perawat Muda PNS 01-12-2003 P2T/5421/03.02/VIII/2016 s/d 02-06-2021 434/SIPP/XI/2016 s/d 02-06-2021
74 Dwi Didik Kurniawan, A.Md.Kep L Lamongan, 26/12/1980 Ners / 2012 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/2515/03.02/01/III/2015 s/d 26/12/2020 260/SIK.P/VII/2014 s/d 26/12/2020
75 Wisnu Widi Atmanto, A.Md.Kep L Lamongan, 17-12-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/7492/03.02/01/IX/2013 s/d 17/12/2018 s/d 17/12/2018
76 Eko Hany Nur Rohman, A.Md.Kep L Lamongan, 25-04-1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2012 P2T/7022/03.02/02/X/2016 s/d 25/04/2021 295/SIPP/VII/2017 s/d 25/04/2021
77 Ilham Fatkul Karim, A.Md.Kep L Lamongan, 13-04-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/2394/03.02/02/III/2018 s/d 13/04/2023 3661/SIPP.I/413.111/XI/2018.P1 s/d 13/04/2023
78 Lina Anisatul, A.Md.Kep P Lamongan, 05-07-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/4321/03.02/02/V/2017 s/d 05/07/2022 463/SIPP/IX/2017 s/d 05/07/2022
79 Malisa Lutika Mega P, A.Md.Kep P Lamongan, 09-07-1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/6342/03.02/02/VII/2017 s/d 09-07-2022 439/SIPP/VIII/2017 s/d 09-07-2022
80 Nina Puspita, A.Md.Kep P Lamongan, 06-07-1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2007 P2T/7718/03.02/02/XI/2016 s/d 06-07-2021 558/SIPP/XII/2016 s/d 06-07-2021
81 Septika Dyan Anggraeni, A.Md.Kep P Lamongan, 19-03-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2013 P2T/2692/03.02/02/III/2017 s/d 19/03/2022 588/SIPP/XI/2017 s/d 19/03/2022
82 Linda Wulansari, A.Md.Kep P Lamongan, 25 juli 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11642/03.02/01/XI/2015 s/d 25-07-2020 538/SIPP/X/2017 s/d 25-07-2020
83 Edi Sumono, A.Md.Kep L Lamongan, 10/03/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/1558/03.02/02/I/2017 s/d 10-03-2022 610/SIPP/XI/2017 s/d 10-03-2022
84 Zakka Yudha Pratama, A.Md.Kep L Lamongan, 02-03-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2013 P2T/1968/03.02/02/II/2017 s/d 02-03-2022 726/SIPP/VIII/2017 s/d 02-03-2022
85 Ulmarofah, A.Md.Kep P Lamongan, 07 -07-1983 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 02/01/2008 P2T/683/03.02/02/I/2016 s/d 07-07-2021 195/SIPP/VI/2016 s/d 07-07-2021
86 Satria Budi Pramana, A.Md.Kep L Lamongan, 4 juli 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11614/03.02/01/XI/2015 s/d 04-07-2020 449/SIPP/IX/2017 s/d 04-07-2020
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
87 Solfiyatul Fitriyah, A.Md.Kep P Lamongan, 06-03-1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/9104/03.02/01/XII/2016 s/d 06-03-2021 440/SIPP/VIII/2017 s/d 06-03-2021
88 Fitri Rosyidah, S.Kep.Ners P gresik, 29 msret 1987 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2982/03.02/02/III/2017 s/d 29-03-2022 293/SIPP/VII/2017 s/d 29-03-2022
89 Lilis Suryaningsih, A.Md.Kep P Lamongan, 24 maret 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8742/03.02/01/XI/2016 s/d 24-03-2021 394/SIPP/VII/2017 s/d 24-03-2021
90 Diniatul Amaliyah, A.Md.Kep P Lamongan, 24-05-1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8801/03.02/01/XI/2016 s/d 24/05/2021 441/SIPP/VIII/2017 s/d 24/05/2021
91 Poniti Dwi Lestari, A.Md.Kep P Lamongan, 3 juni 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 1/5/2017 P2T/8753/03.02/01/XI/2016 s/d 03-06-2021 292/SIPP/VII/2017 s/d 03-06-2021
92 Nurul Islami, A.Md.Kep P Lamongan 2 desember 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8774/03.02/01/XI/2016 s/d 02/12/2021 300/SIPP/VII/2017 s/d 02/12/2021

93 Ina Argayanti, S.Kep.Ners P Lamongan, 07/03/1988 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/2744/03.02/02/III/2017 s/d 07/03/2022 2715/SIPP.1/413.111/VII/2018 s/d 07/03/2022
94 Mohammad Fajar Zulianto, A.Md.Kep L Lamongan, 24/07/1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T10107/03.02/01/XII/2017 s/d 24/07/2022 2369/SIPP.I/413.111/VII/2018 s/d 24/07/2022
95 Hidayatul Khoiroh, S.Kep.Ners P Gresik, 11/07/1967 Ners / 2011 PERAWAT Perawat Madya PNS 01-03-1990 P2T/4296/03.02/02/V/2017 s/d 11-07-2022 790/SIPP.I/413.111/III/2018 s/d 11-07-2022
96 Anita Yusi Safitri, A.Md.Kep P Lamongan, 11/09/1978 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/1651/03.02/01/II/2017 s/d 11/09/2022 96/SIPP/III/2017 s/d 11/09/2022
97 Dwi Nur Mahmudah, A.Md.Kep P Lamongan, 08/03/1982 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/01/2007 P2T/1659/03.02/01/II/2017 s/d 08/03/2022 97/SIPP/III/2017 s/d 08/03/2022
98 Heny Damayanti, S.Kep.Ners P Lamongan, 21/03/1987 Ners / 2011 PERAWAT Perawat Muda PNS 01-01-2011 P2T/6360/03.02/02/IX/2016 s/d 21/03/2021 388/SIPP/XI/2016 s/d 21/03/2021
99 Feti Rahayu Indriyatiningsih, S.Kep Ns P Lamongan, 16/01/1982 Ners / 2013 PERAWAT Perawat Pertama PNS 01/01/2007 P2T/231/03.02/02/I/2019 s/d 16-01-2024 325/SIPP.I/413.111/II/2019.P1 s/d 16-01-2024
100 Jefry Mahardika, S.Kep.Ns L Lamongan, 01-06-1990 Ners / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/5607/03.02/01/IV/2014 s/d 01/06/2019 285/SIPP/VII/2017 s/d 01/06/2019
101 Mariatus Solikhah, A.Md.Kep P Lamongan, 10-07-1982 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2009 P2T/5350/03.02/02/IV/2015 s/d 01/07/2020 205/SIPP/VI/2016 s/d 01/07/2020
102 Munzaeni, S.Kep.Ners L Lamongan, 07/05/1974 Ners / PERAWAT Perawat Muda PNS 01-03-1996 P2T/1875/03.02/02/IV/2019 s/d 07/05/2024 1989/SIPP.I/413.111/VII/2019.P1 s/d 07/05/2024

103 Siti Sukayah, A.Md.Kep P Lamongan, 30/01/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/1303/03.02/02/I/2017 s/d 30-01-2022 721/SIPP/VIII/2017 s/d 30-01-2022
104 Suharsono, A.Md.Kep L Lamongan, 07/12/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/9274/03.02/02/XI/2017 s/d 07/12/2022 950/SIPP.I/413.111/III/2018.P1 s/d 07/12/2022
105 Uswatun Hasanah, A.Md.Kep P Lamongan, 10-10-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/5112/03.02/02/X/2018 s/d 10/10/2023 3660/SIPP.P/413.111/XI/2018.P1 s/d 10/10/2023

106 Dewi Damayanti, A.Md.Kep P Lamongan, 30/03/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/741/03.02/02/II/2019 s/d 30/03/2024 469/SIPP.I/413.111/III/2019.P1 s/d 30/03/2024
107 Nunun Tilawati Setyo Fama, S.Kep.Ners P Lamongan, 30 maret 1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8394/03.02/01/XI/2016 s/d 30-03-2021 287/SIPP/VIII/2017 s/d 30-03-2021
108 Solifuddin, A.Md.Kep L Lamongan, 28-02-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3976/03.02/01/VI/2016 s/d 28-02-2021 442/SIPP/VIII/2017 s/d 28-02-2021
109 Khoirul Zainuddin Nasution, A.Md.Kep L Lamongan, 25 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/802/03.02/02/II/2010 s/d 25-12-2024 1990/SIPP.I/413.111/VII/2019 s/d 25-12-2024
1988
110 Afif Fajar Muhammadi, S.Kep.Ners L Lamongan, 10 oktober 1987 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/249/03.02/01/I/2014 s/d 10-10-2019 282/SIPP/VII/2017 s/d 10-10-2019

111 Ika Syahtia Hidayati, S.Kep.Ners P Lamongan, 26 juni 1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 16 01 7 2 1 18-2305882 s/d 26-06-2023 3641/SIPP.P/413.111/X/2018.P1 s/d 26-06-2023
112 Maslahatul Hidayah, A.Md.Kep P Lamongan, 31 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8911/03.02/01/XII/2016 s/d 31-12-2021 284/SIPP/VII/2017 s/d 31-12-2021
1994
113 Nursahril Likarevil, A.Md.Kep P lamongan, 7 oktober 1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 1601521 18-2222323 s/d 07-10-2023 327/SIPP/VIII/2017 s/d 07-10-2023
114 Abdi Harianto, A.Md.Kep L Lamongan, 08/11/1986 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/8917/03.02/02/X/2017 s/d 07/11/2022 620/SIPP/XI/2017 s/d 07/11/2022
115 Naimatun, A.Md.Kep P Lamongan, 08/06/1979 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/9065/03.02/02/XI/2017 s/d 08/06/2022 629/SIPP/XI/2017 s/d 08/06/2022
116 Dzakiy Muhandis, S.Kep.Ners L Lamongan., 21 januari 1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10153/03.02/01/X/2015 s/d 21-01-2020 628/SIPP/XI/2017 s/d 21-01-2020

117 Wieke Artanty Puspitasari, S.Kep.Ners P Lamongan, 14-11-1987 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8899/03.02/02/X/2017 s/d 14/11/2022 609/SIPP/XI/2017 s/d 14/11/2022
118 Intan Pratiwi, A.Md.Kep P Lamongan, 19/01/1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/8745/03.02/01/XI/2016 s/d 19/01/2021 2371/SIPP.I/413.111/VII/2018 s/d 19/01/2021
119 Ryandeaz Candraw, A.Md.Kep L Lamongan, 25/05/1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 5 1 1 16-1179436 s/d 25/05/2021 2592/SIPP.I/413.111/VII/2018 s/d 25/05/2021
120 Mustadi, S.Kep., NS L Lamongan, 15/02/69 Ners / 2011 PERAWAT Perawat Muda PNS 01-03-1990 P2T/622/03.02/02/I/2017 s/d 15/02/2022 52/SIPP/II/2017 s/d 15/02/2022
121 Deni Wahyuni Marfiati, A.Md.Kep P Lamongan, 27/12/1979 Ners / 2013 PERAWAT Perawat Mahir PNS 01-02-2009 P27/1966/03.02/01/II/2014 s/d 27/12/2019 126/SIK.P/IV/2015 s/d 27/12/2019
122 Dwi Yuni Aristi, A.Md.Kep P Lamongan, 04/06/1984 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS P2T/9073/03.02/02/XI/2017 s/d 04-06-2022 621/SIPP/XI/2017 s/d 04-06-2022
123 Erna Widayati, S.Kep.Ns P Lamongan, 24-04-1988 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/3035/03.02/02/V/2018 s/d 24-04-2023 3486/SIP.P/413.111/X/2018.P1 s/d 24-04-2023
124 Fakhrudin Arifatul Fatoni, A.Md.kep L Lamongan, 01-04-1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2012 P2T/10562/03.02/02/X/2015 s/d 01-04-2020 385/SIPP/XI/2016 s/d 01-04-2020
125 Sri Dian Ningseh, A.Md.Kep P Lamongan, 29/11/1987 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/760/03.02/01/I/2018 s/d 29/11/2023 010/SIPP.I/413.111/II/2018 s/d 29/11/2023
126 Sutarto, A.Md.Kep L Lamongan, 04-04-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/2779/03.02/02/III/2017 s/d 04-04-2022 719/SIPP/VIII/2017 s/d 04-04-2022
127 Tri Yuli Utami, A.Md.Kep P Lamongan, 27-07-1984 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/09/2015 P2T/4240/03.02/02/IX/2018 s/d 17/09/2023 386/SIPP/XI/2016 s/d 17/09/2023
128 Harun Rosyid,S.Kep.Ners L Lamongan, 16/10/1973 Ners / 2013 PERAWAT Perawat Muda PNS 01/03/1996 P27/1978/03.02/01/II/2014 s/d 16-10-2019 723/SIPP/VIII/2017 s/d 16-10-2019
129 Nis Srianti, S.Kep.Ners P Lamongan, 01/03/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/8764/03.02/01/X/2017 s/d 01-03-2022 727/SIP/VIII/2017 s/d 01-03-2022
130 Afik Dwi Saputro, A.Md.Kep L Lamongan, 01/12/1985 Ners / 2012 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/5482/03.02/02/X/2018 s/d 01/12/2023 4104/SIPP.I/413.111/XII/2018.P1 s/d 01/12/2023
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
131 Idawati, A.Md.Kep P Lamongan, 14 februari 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8912/03.02/01/XII/2016 s/d 14-02-2021 274/SIPP/VII/2017 s/d 14-02-2021

132 Eka Anggraini Aisyah, A.Md.Kep P Lamongan, 31 oktober 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8754/03.02/01/XI/2016 s/d 31-10-2021 333/SIPP/VIII/2017 s/d 31-10-2021

133 Salviyah Eka Nur Indriyani, S.Kep.Ners P Lamongan, 17 maret 1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10874/03.02/01/X/2015 s/d 17-03-2020 275/SIPP/VII/2017 s/d 17-03-2020
134 Nafa Ulya, A.Md.Kep P Lamongan, 3 juni 1995 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8881/03.02/01/XII/2016 s/d 03-06-2021 331/SIPP/VIII/2017 s/d 03-06-2021
135 Ibrahim Sobirin, S.Kep.Ners L Lamongan, 23-7-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3174/03.02/02/VII/2019 s/d 23/07/2024 2299/SIPP.I/413.111/IX/2019.P1 s/d 23/07/2024
136 Guntoro Saikudin, A.Md.Kep L Lamongan, 23 februari 1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10500/03.02/02/X/2015 s/d 23-02-2020 519/SIPP/IX//2017 s/d 23-02-2020

137 Budi Setyo Utomo, S.Kep.Ners L Lamongan, 28 nopember Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/2143/03.02/01/II/2015 s/d 28/11/2020 272/SIPP/VII/2017 s/d 28/11/2020
1990
138 Imam Sulistyono D.P, A.Md.Kep L Nganjuk, 15 sepetemer D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/7821/03.02/02/IX/2017 s/d 15-09-2022 517/SIPP/IX/2017 s/d 15-09-2022
1990
139 Lilis Ekawati, S.Kep.Ners P Lamongan, 08-04-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/03/2013 P2T/271/03.02/01/I/2014 s/d 08-04-2019 33/SIK.P/I/2014 s/d 08-04-2019
140 Ari Isroh Eka Rahayu, A.Md.Kep P Lamongan, 27/03/1987 D3 Keperawatan PERAWAT Perawat Mahir PNS 01/01/2011 P2T/790/03.02/02/II/2019 s/d 27-03-2024 537/SIPP.1/413.111/III/2019.P1 s/d 27-03-2024
141 isvantri, A.Md.Kep L Lamongan, 07/10/1990 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 5 1 1 16-1201503 s/d 07/10/2021 2384/SIPP.I/413.111/VII/2018 s/d 07/10/2021
142 Nur Elisa Ratnafifka, A.md.Kep P Lamongan, 21/06/1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/9919/03.02/01/XII/2017 s/d 21/06/2022 2378/SIPP.I/413.111/VII/2018 s/d 21/06/2022
143 Nunuk Yasofah, S.Kep.Ners P Gresik, 12/06/1970 Ners / 2013 PERAWAT Perawat Muda PNS 01/03/1997 P2T/2043/03.02/02/V/2019 s/d 12/06/2024 2169/SIPP.I/413.111/VIII/2019.P1 s/d 12/06/2024

144 Moh. Doni Sokifyanto, A.Md.Kep L Lamongan, 18/01/1980 Ners / 2016 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/2023/03.02/01/II/2017 s/d 18/01/2022 482/SIPP/IX/2017 s/d 18/01/2022
145 M. Mahfud Shodri, A.Md.Kep L Lamongan, 24-02-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/1548/03.02/02/II/2018 s/d 24/02/2023 810/SIPP.I/413.111/III/2018.P1 s/d 24/02/2023
146 M. Zuli Hardiansyah, A.Md.Kep L Lamongan, 20-07-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 160151118-2374326 s/d 20/07/2023 2166/SIPP.I/413.111/VIII/2019.P1 s/d 20/07/2023

147 Moh. Afifullah Hanafi, A.Md.Kep L Lamongan, 21-03-1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2014 P2T/2780/03.02/02/III/2017 s/d 21/03/2022 722/SIPP/VIII/2017 s/d 21/03/2022
148 Ari Dyah Lestari, S.Kep.Ners P Lamongan, 11/08/1984 Ners / PERAWAT Perawat Mahir PNS 01/01/2010 P2T/762/03.02/01/I/2018 s/d 21/08/2023 715/SIPP/VIII/2017 s/d 21/08/2023
149 Renny Wulan Yunatiningsih, S.Kep.Ners P Jember, 31/05/1982 Ners / 2017 PERAWAT Perawat Mahir PNS 01/01/2007 P2T/3297/03.02/01/IV/2017 s/d 31/05/2022 291/SIPP.I/413.111/II/2019.P1 s/d 31/05/2022
150 Sekarwati, A.Md.Kep P Lamongan, 02/06/1983 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/9069/03.02/02/XI/2017 s/d 02/07/2022 623/SIPP/XI/2017 s/d 02/07/2022
151 Susila, A.Md.Kep L Lamongan, 18-01-1985 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/08/2015 P2T/197/03.02/02/I/2015 s/d 18/01/2020 383/SIPP/XI/2016 s/d 18/01/2020
152 Dinna Suci Wulan Safitri, A.Md.Kep P Lamongan, 10-03-1992 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/765/03.02/02/I/2018 s/d 10/03/2023 008/SIPP.I/413.111/II/2018 s/d 10/03/2023
153 Nanik Susanti, S.Kep.Ners P Lamongan, 27-11-1986 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/13151/03.02/02/XI/2015 s/d 27/11/2020 335/SIPP/VIII/2017 s/d 27/11/2020
154 Intan Purvasi, A.Md.Kep P Lamongan, 15-07-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/8979/03.02/01/XII/2016 s/d 15-07-2021 334/SIPP/VIII/2017 s/d 15-07-2021
155 Heri Setiawan, A.Md.Kep L Lamongan, 1 desember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160151118-2405651 s/d 01-12-2023 505/SIPP/IX/2017 s/d 01-12-2023
1992
156 Inayah, A.Md.Kep P Lamongan, 12 januari 1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152118-2404834 s/d 12-01-2023 2301/SIPP.I/413.111/IX/2019.P1 s/d 12-01-2023
157 Misbakhun Nizar, A.Md.Kep L Lamongan, 16-04-1988 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/315/03.02/02/I/2016 s/d 16-04-2021 451/SIPP/IX/2017 s/d 16-04-2021
158 Suliswanto, A.Md.Kep L Tuban, 9 mei 1988 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11427/03.02/02/X/2015 s/d 09/05/2020 631/SIPP/XI/2017 s/d 09/05/2020
159 Fita Novy Porwaningtyas, A.Md.Kep P Lamongan, 4 nopember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 160152118-2222319 s/d 04/11/2023 291/SIPP/VII/2017 s/d 04/11/2023
1993
160 Amlikhatus Shofa, A.Md.Kep P Lamongan, 27-10-1993 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/7526/03.02/01/IX/2014 s/d 27-10-2019 551/SIPP/X/2017 s/d 27-10-2019
161 Nurul Anisa, A.Md.Kep P Lamongan, 5 agustus 1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/3832/03.02/01/III/2014 s/d 05-08-2019 290/SIPP/VII/2017 s/d 05-08-2019
162 Aily Mufidah, A.Md.Kep P Lamongan, 18/10/1996 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/10066/03.02/01/XII/2017 s/d 18/10/2022 2378/SIPP.I/413.111/VII/2018 s/d 18/10/2022
163 Benny Afandi Purwanto, S.Kep.Ners L Lamongan, 06/09/1992 Ners / PERAWAT PERAWAT Kontrak BLUD 01/10/2018 P2T/7724/03.02/01/IX/2017 s/d 06/09/2022 2377/SIPP.I/413.111/VII/2018 s/d 06/09/2022
164 Basuseno, S.Kep.Ners L Lamongan, 25/05/1988 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 16 01 7 1 1 18-2245104 s/d 25/05/2023 3245/SIPP.I/413.111/IX/2018 s/d 25/05/2023
165 Suwaji, S.Kep., NS L Lamongan, 25/07/1965 Ners / 2011 PERAWAT Perawat Madya PNS 01-01-1988 P2T/5207/03.02/02/VI/2017 s/d 25/07/2022 174/SIPP/XI/2017 s/d 25/07/2022
166 Nuroiniatul Hidayah, A.Md.kep P Lamongan, 04-11-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/06/2015 P2T/5689/03.02/02/XI/2018 s/d 04-11-2023 4114/SIPP.I/413.111/XIII/2018.P1 s/d 04-11-2023

167 Eli Purdiawati, A.Md.Kep P Lamongan, 02 -01-1980 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/03/2007 P2T/6196/03.02/01/V/2015 s/d 02/01/2020 364/SIPP/X/2016 s/d 02/01/2020
168 Elis Setiari, A.Md.Kep P Lamongan, 29-02-1984 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/04/2008 P2T/1820/03.02/02/II/2017 s/d 29/02/2022 705/SIPP/XII/2017 s/d 29/02/2022
169 Samiadi, A.Md.Kep L Lamongan, 21-05-1981 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/11/2008 P2T/5692/03.02/02/XI/2018 s/d 21/05/2023 4044/SIPP.I/413.111/XII/2018.P1 s/d 21/05/2023

170 Ismi Badriyah, S.Kep.Ners P Lamongan, 11/06/1977 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/7300/03.02/01/VI/2015 s/d 11-06-2020 3485/SIPP.I/413.111/X/2018 s/d 11-06-2020
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
171 Fitriyatus Solikhah, A.Md.Kep P Lamongan, 29/07/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/4223/03.02/02/IX/2018 s/d 29-07-2023 4105/SIPP.I/413.111/XII/2018.P1 s/d 29-07-2023

172 Umi Mariati, S.Kep.Ners P Lamongan, 18/03/1980 Ners / 2012 PERAWAT Perawat Pertama PNS 01/04/2006 P2T/709/03.02/02/II/2019 s/d 18/03/2024 315/SIPP.I/413.111/III/2019.P1 s/d 18/03/2024
173 Ismi Azizah, A.Md.Kep P Lamongan, 5 nopember D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/11625/03.02/01/XI/2015 s/d 05-11-2020 279/SIPP/VII/2017 s/d 05-11-2020
1993
174 Wawan Widiyanto, A.Md.Kep L Lamongan, 02-06-1991 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/1887/03.02/02/IV/2019 s/d 02-06-2024 1987/SIPP.I/413.111/VII/2019.P1 s/d 02-06-2024

175 Riska Prihantini, S.Kep.Ners P Lamongan, 19-4-1989 Ners / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/232/03.02/02/I/2019 s/d 19-04-2024 s/d 19-04-2024
176 Zaitun Ulfa, A.Md.Kep P Lamongan, 03-05-1994 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/1966/03.02/02/II/2017 s/d 03-04-2020 287/SIPP/VII/2017 s/d 03-04-2020
177 Felani Agus Susanto, A.Md.Kep L Lamongan, 5 agustus 1989 D3 Keperawatan / PERAWAT PERAWAT Kontrak BLUD 01/05/2017 P2T/10488/03.02/02/X/2015 s/d 05-08-2020 280/SIPP/VII/2017 s/d 05-08-2020
178 Erwin Suhartono, S.Kep.Ners L Lamongan, 08/08/1987 Ners / PERAWAT PERAWAT Kontrak BLUD 8/1/2018 P2T/2813/03.02/02/VIII/2019.P1 s/d 08/08/2024 2890/SIPP.I/413.111/VIII/2019.P1 s/d 08/08/2024

179 Ahmad Bahruddin, S.Kep.Ns L Lamongan, 22/08/1987 Ners / PERAWAT Perawat Kontrak BLUD 01/10/2018 P2T/7071/03.02/02/VIII/2017 s/d 22/08/2022 2374/SIPP.I/413.111/VII/2018 s/d 22/08/2022
180 Nurul Chayatin, S.Kep, NS P Lamongan, 29/11/1976 Ners / 2002 PERAWAT Perawat Muda PNS 01/04/2006 P2T/3647/03.02/02/V/2016 s/d 29-11-2021 429/SIPP/XI/2016 s/d 29-11-2021
181 Abdul Muchid, A.Md.Kep L Lamongan, 25/06/1989 D3 Keperawatan / 2010 PERAWAT Perawat Mahir PNS 01/10/2011 P2T/10495/03.02/02/X/2015 s/d 25/06/2020 259/SIK.P/VIII/2013 s/d 25/06/2020
182 Abd. Rouf Khoiri, S.Kep.Ners L Lamongan, 16/08/1974 Ners / 2013 PERAWAT Perawat Muda PNS 01/01/2000 P2T/1989/03.02/01/II/2014 s/d 16/08/2019 62/SIPP/II/2017 s/d 16/08/2019
183 Afandi Mulyono, A.Md.Kep L Lamongan, 13/11/1977 Ners / 2016 PERAWAT Perawat Mahir PNS 01/12/2003 P2T/1840/03.02/01/II/2017 s/d 13/11/2022 485/SIIPP/XI/2016 s/d 13/11/2022
184 Cahya Taufiq Rakhman, A.Md.Kep L Lamongan, 06/01/1987 D3 Keperawatan / 2009 PERAWAT Perawat Mahir PNS 01-10-2011 P2T/1672/03.02/01/II/2015 s/d 06/01/2020 447/SIPP/XI/2016 s/d 06/01/2020
185 Dewi Ismauliyati, A.Md.Kep P Lamongan, 10 -12- 1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 02/01/2008 P2T/7463/03.02/02/XI/2016 s/d 10/12/2021 394/SIPP/XI/2016 s/d 10/12/2021
186 Asma’ul Husna, A.Md.Kep P Lamongan, 08/10/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/5548/03.02/01/IV/2015 s/d 08/10/2020 427/SIPP/XI/2016 s/d 08/10/2020
187 Evi Savitri, A.Md.Kep P Lamongan, 16-03-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/1888/03.02/02/III/2018 s/d 16/03/2023 3494/SIPP.I/413.111/X/2018.P1 s/d 16/03/2023
188 Hardika Yudhatama, S.Kep.Ns L Jakarta, 08-06-1990 Ners / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/259/03.02/01/I/2014 s/d 08/06/2019 422/SIPP/XI/2016 s/d 08/06/2019
189 Irfan Mahardika Crismiharso, A.Md.Kep L Lamongan, 17/08/1987 D3 Keperawatan / 2009 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/2302/03.02/01/III/2016 s/d 17-08-2021 655/SIPP/XII/2017 s/d 17-08-2021
190 Isti’anah, S.Kep.Ners P Lamongan, 25/10/1980 Ners / 2014 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/7110/03.02/01/VIII/2017 s/d 25/10/2022 653/SIPP/XII/2017 s/d 25/10/2022
191 Kholipah, A.Md.Kep P Lamongan, 14-07-1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 02/01/2008 P2T/3076/03.02/02/IV/2016 s/d 14-07-2021 396/SIPP/XI/2016 s/d 14-07-2021
192 Moh. Basuki , A.Md.Kep L Lamongan, 23/04/1981 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01-12-2003 P2T/712/03.02/02/II/2019 s/d 23/04/2024 s/d 23/04/2024
193 M. Nur ali, S.Kep.Ners L Lamongan, 15/11/1976 Ners / 2013 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/7210/03.02/01/VI/2015 s/d 15/11/2020 424/SIPP/XI/2016 s/d 15/11/2020
194 M. Sholeh, S.Kep.Ners L Lamongan, 17/04/1973 Ners / 2014 PERAWAT Perawat Penyelia PNS 01-03-1996 P2T/7108/02.03/01/VIII/2017 s/d 17/04/2022 1287/SIPP.I/413.111/IV/2018 s/d 17/04/2022
195 Nurhadi, A.Md.Kep L Lamongan, 20/07/1970 D3 Keperawatan / 2009 PERAWAT Perawat Penyelia PNS 01-02-1993 P2T/3077/03.02/01/IV/2016 s/d 20-07-2021 387/SIPP/XI/2016 s/d 20-07-2021
196 Pramono Adinata, A.Md.Kep L Lamongan, 26/01/1982 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/406/03.02/02/I/2016 s/d 20-01-2021 423/SIPP/XI/2016 s/d 20-01-2021
197 Ria Utami Widiastutik, A.Md.Kep P Lamongan, 31/08/1984 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01-01-2011 P2T/4338/03.02/02/VI/2016 s/d 31-08-2021 392/SIPP/XI/2016 s/d 31-08-2021
198 Rochmat Abdullah, A.Md.Kep L Lamongan, 04/02/1982 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/1189/03.02/02/II/2018 s/d 04/02/2023 3488/SIPP.I/413.111/X/2018 s/d 04/02/2023
199 Siswanto, A.Md.Kep L Surabaya, 15/12/1981 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/936/03.02/02/I/2016 s/d 15-12-2021 207/SIPP/XII/2017 s/d 15-12-2021
200 Sukriya Dini Puspawati, A.Md.Kep P Lamongan, 25/06/1978 D3 Keperawatan / 2006 PERAWAT PNS P2T/1850/03.02/02/II/2018 s/d 14/01/2023 3489/SIPP.I?413.111/X/2018 s/d 14/01/2023
201 Mukhamad Zudi, A.Md.Kep L Lamongan, 26/02/1984 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/2417/03.02/02/IV/2018 s/d 26/02/2023 2383/SIPP.I?413.111/VI/2018.P1 s/d 26/02/2023

202 Widiyawati, A.Md.Kep P Lamongan, 13 -01-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/3534/03.02/02/V/2016 s/d 13/01/2021 190/SIPP/VI/2016 s/d 13/01/2021
203 Mu'afah, S.Kep.Ns P Lamongan, 27/01/1962 Ners / 2011 PERAWAT Perawat Madya PNS 01-03-1984 P2T/1363/03.02/02/I/2017 s/d 27-01-2021 2/SIK.P/XII/2016 s/d 27-01-2021
204 Agus Suwandito, A.Md.Kep L Lamongan, 8 -08-1980 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/6886/03.02/02/X/2016 s/d 05/08/2022 05/SIPPA/VIII/2017 s/d 05/08/2022
205 Anastri Pavi Mindaria, A.Md.Kep P Pacitan, 04/04/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/10068/03.02/02/X/2015 s/d 04-04-2020 389/SIPP/XI/2016 s/d 04-04-2020
206 Doni Firmansah, A.Md.Kep L Lamongan, 25/05/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2010 161551116-1145663 s/d 25/05/2021 02/SIPPA/VIII/2017 s/d 25/05/2021
207 Endang Anik Yuliyah, A.Md.Kep P Lamogan, 24/01/1978 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/4457/03.02/02/III/2015 s/d 24-01-2020 09/SIPP/I/2016 s/d 24-01-2020
208 Jerry Pramono Putro, A.Md.Kep L Lamongan, 16/08/1978 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/5734/03.02/02/V/2014 s/d 16-08-2019 03/SIPPA/VIII/2017 s/d 16-08-2019
209 M. Ikhwan, A.Md.Kep L Lamongan, 31-12-1990 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/7024/03.02/02/X/2016 s/d 31-12-2021 445/SIPP/XI/2016 s/d 31-12-2021
210 Nunik Aliyah Ulfa, A.Md.Kep P Lamongan, 22/06/81 Ners / 2014 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/6993/03.02/01/VI/2015 s/d 22-06-2020 391/SIPP/XI/2016 s/d 22-06-2020
211 Suliana, A.Md.Kep P Lamongan, 27/09/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/5323/03.02/02/IV/2015 s/d 27-09-2020 390/SIPP/XI/2016 s/d 27-09-2020
212 Supardi, A.Md.Kep L Lamongan, 26/06/1974 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/12/2013 161551117-1443958 s/d 26-06-2022 01/SIPPA/VIII/2017 s/d 26-06-2022
213 Wahyu Nur Jannah, A.Md.Kep P Lamongan, 18-12-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7522/03.02/01/IX/2014 s/d 18-12-2019 200/SIPP/VI/2016 s/d 18-12-2019
214 Abdur Ruchman Sulichan, A.Md.Kep L Lamongan, 05/10/1990 D3 Keperawatan / PERAWAT Perawat Kontrak 01/04/2016 P2T/7826/03.02/02/IX/2017 s/d 05-10-2022 2057/SIPP.I/413.111/V/2018.P1 s/d 05-10-2022
Pemda
215 Ahmad Susanto, A.Md.Kep L Lamongan, 28/04/1982 Ners / 2016 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/751/03.02/03/II/2019 s/d 28-04-2024 481/SIPP/XI/2016 s/d 28-04-2024
216 Siti Sridayati, A.Md.Kep P Lamongan, 14-10-1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/6862/03.02/02/X/2016 s/d 24/10/2021 150/SIPP/IV/2017 s/d 24/10/2021
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
217 Siti Nurjanah , A.Md.Kep P Lamongan, 25/12/1981 D3 Keperawatan / 2003 PERAWAT PNS 01/01/2007 P2T/1860/03.02/02/II/2018 s/d 25/12/2023 3248/SIPP.I/413.111/IX/2018.P1 s/d 25/12/2023
218 Aji Suyono, S.Kep.Ners L Bojonegoro, 04/10/1969 Ners / 2011 PERAWAT Perawat Muda PNS 01/12/2000 P2T/8879/03.02/02/X/2017 s/d 04/10/2022 949/SIPP.I/413.111/III/2018.P1 s/d 04/10/2022
219 Abdul Hamid, A.Md.Kep L Lamongan, 19-01-1989 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/7025/03.02/02/X/2016 s/d 19/01/2021 446/SIPP/XI/2016 s/d 19/01/2021
220 Agus Zaenal, S.Kep., Ns L Lamongan, 12/08/1969 Ners / 2013 PERAWAT Perawat Muda PNS 15/07/2010 P2T/2384/03.02/01/II/2017 s/d 12/08/2022 3483/SIPP.I/413.111/X/2018.P1 s/d 12/08/2022
221 Aini Fatmawati, A.Md.Kep P Lamongan, 02/11/1983 D3 Keperawatan / 2006 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/5810/03.02/VIII/2016 s/d 02/11/2021 426/SIPP/XI/2016 s/d 02/11/2021
222 Puguh Jaya Setiawan, S.Kep.Ns L Lamongan, 11-08-1987 Ners / PERAWAT Perawat Kontrak BLUD 01/03/2013 P2T/4310/03.02/02/X/2018 s/d 11/08/2023 4107/SIPP.I/413.111/XII/2018.P1 s/d 11/08/2023

223 Bathi Susanto, A.Md.Kep L Lamongan, 22/07/1975 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 16 01 7 1 1 15-0978076 s/d 22/07/2020 164/SIPP/IV/2017 s/d 22/07/2020
224 Dian Anggraini, A.Md.Kep P Lamongan, 27/08/1981 Ners / 2018 PERAWAT Perawat Mahir PNS 01-12-2012 P2T/7222/03.02/02/VIII/2017 s/d 27/08/2022 642/SIPP/XIII/2017 s/d 27/08/2022
225 Faris Eko CP, A.Md.Kep L Lamongan, 15 -12- 1980 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 02/01/2008 P2T/9163/03.02/02/XI/2017 s/d 15/12/2022 2382/SIPP.I/413.111/VII/2018.P1 s/d 15/12/2022

226 Hasyim, A.Md.Kep L Lamongan, 05/05/1969 D3 Keperawatan / 2000 PERAWAT Perawat Penyelia PNS 01/03/1989 P2T/1/03.02/02/I/2019 s/d 05/05/2024 539/SIPP.I/413.111/III/2019.P1 s/d 05/05/2024
227 Indah Sulistyowati, A.Md.kep P Lamongan, 15-05-1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/2844/03.02/02/III/2017 s/d 15/05/2022 641/SIPP/XII/2017 s/d 15/05/2022
228 Iwan Sugandi, A.Md.Kep L Lamongan, 15-04-1987 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2009 P2T/766/03.02/02/I/2014 s/d 15/04/2019 425/SIPP/XI/2016 s/d 15/04/2019
229 Khoirun Nisaak F, A.Md.Kep P Serui, 29-06-1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/9064/03.02/02/XI/2017 s/d 19-07-2022 627/SIPP/XI/2017 s/d 19-07-2022
230 M. Agung Dwi Cahyono, A.Md.Kep L Lamongan, 08-02-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2013 P2T/1256/03.02/02/I/2017 s/d 08-02-2022 624/SIPP/XI/2017 s/d 08-02-2022
231 Moch. Syaeful Hudda, A.Md.Kep L Lamongan, 12/06/1983 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/684/03.02/02/I/2016 s/d 12/06/2021 4108/SIPP.I413.111/XII/2018.P1 s/d 12/06/2021
232 Ratna Hardini, A.Md.Kep P Lamongan, 08-05-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7540/03.02/01/IX/2014 s/d 08/05/2019 198/SIPP/VI/2016 s/d 08/05/2019
233 Rihatul Wardah, A.Md.Kep P Lamongan, 06/03/1987 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/02/2015 P2T/306/03.02/02/I/2019 s/d 06/03/2024 533/SIPP.I/413.111/III/2019.P1 s/d 06/03/2024
234 Ristiyahwati, A.Md.Kep P Lamongan, 21-12-1983 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/11/2008 P2T/5550/03.02/01/IV/2015 s/d 21/12/2020 428/SIPP/XI/2016 s/d 21/12/2020
235 Rudy Hariyanto, A.Md.Kep L Lamongan, 03-06-1987 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2012 P2T/10561/03.02/02/X/2015 s/d 03/06/2020 406/SIPP/VIII/2017 s/d 03/06/2020
236 Suhadak H M, S.Kep.Ns L Lamongan, 15-06-1987 Ners / PERAWAT Perawat Kontrak BLUD 01/03/2014 16 01 7 1 1 18-2305913 s/d 15/07/2023 3657/SIPP.I/413.111/XI/2018.P1 s/d 15/07/2023
237 Tri Martiningtyas, S.kep.Ners P Malang, 01/03/1978 Ners / 2012 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/7106/03.02/01/VIII/2017 s/d 01/03/2022 640/SIPP/XII/2017 s/d 01/03/2022
238 Yulisvionita Ika PB,A.Md.Kep P Lamongan, 12-07-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/4243/03.02/02/IX/2018 s/d 12/07/2023 3654/SIPP.I/413.111/XI/2018.P1 s/d 12/07/2023
239 Zaeni, S.Kep.Ners L Lamongan, 16/01/1980 Ners / 2014 PERAWAT Perawat Pertama PNS 01/04/2006 16 01 7 1 1 15-0978083 s/d 16/01/2020 215/SIPP.I/413.111/I/2019.P1 s/d 16/01/2020
240 M. Masykur, S.Kep.Ners L Lamongan, 12-5-1989 Ners / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/2686/03.02/01/III/2015 s/d 12-05-2020 408/SIPP/VIII/2017 s/d 12-05-2020
241 M. Sholik Faidin, S.Kep.Ns L Lamongan, 26-09-1989 Ners / PERAWAT Perawat Kontrak BLUD 1/7/2014 P2T/5780/03.02/02/XII/2018 s/d 26/09/2023 470/SIPP.I/413.111/III/2019.P1 s/d 26/09/2023
242 Chintya Erlista Avidiana R.S, A.Md.Kep P Lamongan, 16-09-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8770/03.02/01/XI/2016 s/d 16/09/2021 317/SIPP/VIII/2017 s/d 16/09/2021
243 Virdiana Anggraini, A.Md.Kep P Lamongan, 20-07-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8796/03.02/01/XI/2016 s/d 20-07-2021 318/SIPP/VIII/2017 s/d 20-07-2021
244 Niswatul Lailiyah, A.Md.Kep P Lamongan, 9 maret 1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8931/03.02/01/XII/2016 s/d 09-03-2021 578/SIPP/XI/2017 s/d 09-03-2021
245 Harto, S.Kep., Ns L 3524220804720004 PERAWAT PNS P2T/5423/03.02/02/VIII/2016 s/d 08-04-2021 297/SIPP/IX/2016 s/d 08-04-2021
246 Abdul Khohar, A.Md.Kep L Lamongan, 04/09/1977 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/4235/03.02/02/IX/2018 s/d 04-09-2023 3662/SIPP.I/314.111/XI/2018.P1 s/d 04-09-2023
247 Fathurrohman, A.Md.Kep L Lamongan, 18/02/1979 D3 Keperawatan/ 2002 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1435/03.02/02/III/2019 s/d 18-02-2024 2171/SIPP.I/413.111/VIII/2019.P1 s/d 18-02-2024

248 Fita Fatimah, A.Md.Kep P Gresik, 17-10-1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/35/03.02/01/I/2015 s/d 17/10/2020 36/SIK.P/I/2015 s/d 17/10/2020
249 Khayatun Fitriyah, A.Md.Kep P Lamongan, 22/12/1985 D3 Keperawatan/ 2009 PERAWAT Perawat Mahir PNS 01-01-2011 P2T/172/03.02/02/I/2015 s/d 22-12-2020 23/SIK.P/I/2015 s/d 22-12-2020
250 Lisa Umami, S.Kep.Ners P Lamongan, 05/03/1981 Ners / 2015 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1662/03.02/01/II/2017 s/d 05/03/2022 93/SIPP/III/2017 s/d 05/03/2022
251 Nur Asiya, A.Md.Kep P Lamongan, 25/08/1980 Ners /2016 PERAWAT Perawat Pertama PNS 01/04/2006 P2T/1582/03.02/01/I/2017 s/d 25/08/2022 90/SIP.P/III/2017 s/d 25/08/2022
252 Piah, A.Md.Kep P Lamongan, 19/10/1977 D3 Keperawatan/ 2009 PERAWAT Perawat Pelaksana PNS 01/04/2006 P2T/5483/03.02/02/X/2018 s/d 19/10/2023 4039/SIPP.I/413.111/XII/2018.P1 s/d 19/10/2023

253 Siti Fadhilah, A.Md.Kep P Lamongan, 15/05/1982 D3 Keperawatan/ 2003 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/36/03.02/01/I/2015 s/d 15/05/2020 35/SIK.P/I/2015 s/d 15/05/2020
254 Umu Choiriyah, A.Md.Kep P Lamongan, 19/03/1980 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1556/03.02/02/I/2017 s/d 19/03/2022 92/SIPP/III/2017 s/d 19/03/2022
255 Cicik Mashula, A.Md.Kep P 3524154909790003 D3 Keperawatan / 2000 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/3986/03.02/02/III/2015 s/d 09/09/2020 125/SIK.P/IV/2015 s/d 09/09/2020
256 Toni Yulianto, A.Md.Kep L Lamongan, 22/07/1983 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01-01-2010 P2T/616/03.02/02/I/2016 s/d 22-07-2021 225/SIPP/VII/2016 s/d 22-07-2021
257 Habibi Ika Kurnianto, A.Md.Kep L Lamongan, 11-01-1986 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2009 P2T/10600/03.02/02/XII/2016 s/d 11/01/2021 4042/SIPP.I/413.111/XII/2018.P1 s/d 11/01/2021

258 Yulikah, A.Md.Kep P Lamongan, 16-01-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/613/03.02/02/I/2016 s/d 16-01-2021 224/SIPP/VII/2016 s/d 16-01-2021
259 Eko Yulianto Kuswandono, A.Md.Kep L Lamongan, 25/07/1983 Ners / 2013 PERAWAT Perawat Mahir PNS 01-02-2009 P2T/7627/03.02/01/VII/2015 s/d 25-07-2020 217/SIK.P/VII/2015 s/d 25-07-2020
260 Arifatul Fauziyah, A.Md.Kep P Lamongan, 09-03-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 160152118-2391431 s/d 09/03/2023 1976/SIPP.I/413.111/VII/2019.P1 s/d 09/03/2023

261 Suiswanto, S.ST L Lamongan, 12/05/1977 D4 Keperawatan / 201I PERAWAT Perawat Mahir PNS 01-12-2003 16 01 6 1 1 16-1115683 s/d 12/05/2021 2029/SIPP.I/413.111/V/2018.P1 s/d 12/05/2021
262 Budi Riyanto, A.Md.Kep L Madiun, 20/10/1974 D3 Keperawatan / 2003 PERAWAT Perawat Penyelia PNS 01-12-2003 P27/5574/03.02/02/IV/2014 s/d 20/10/2019 227/SIK.P/VI/2014 s/d 20/10/2019
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
263 Sri Indrawati, A.Md.Kep P Lamongan, 04/11/1982 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/01/2007 P2T/37/03.02/01/I/2015 s/d 04/11/2020 37/SIK.P/I/2015 s/d 04/11/2020
264 Sri Sudarwati, A.Md.Kep P Lamongan, 04/04/1980 D3 Keperawatan / 2001 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/320/03.02/01/I/2015 s/d 04/04/2020 34/SIK.P/I/2015 s/d 04/04/2020
265 Risa, A.Md.Kep P Lamongan, 27/05/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/5586/03.02/02/IV/2014 s/d 27/05/2019 232/SIK.P/VI/2014 s/d 27/05/2019
266 Nur Choerun Azari, A.Md.Kep L Lamongan, 23 -05 -1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/7237/03.02/02/X/2016 s/d 23/05/2021 555/SIPP/XII/2016 s/d 23/05/2021
267 Ahmad Rifa’i Subagiyo, S.Kep.Ners L Lamongan, 15/02/1985 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/7988/03.02/01/XI/2016 s/d 15/02/2021 165/SIPP/VIII/2017 s/d 15/02/2021
268 Nurhayati Dwi Sulistyoningsih, A.Md.Kep P Lamongan, 04/10/1989 D3 Keperawatan / 2010 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/11426/03.02/02/X/2015 s/d 04/10/2020 394/SIK.P/XII/2015 s/d 04/10/2020
269 Syangga Diwangga, A.Md.Kep L Lamongan, 26-04-1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/1454/03.02/02/III/2019 s/d 26/04/2024 1828/SIPP.I/413.111/VI/2019.P1 s/d 26/04/2024
270 Ida Rahmawati, A.Md.Kep P Lamongan, 04/05/1986 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/9130/03.02/02/XI/2017 s/d 04-05-2022 626/SIPP/XI/2017 s/d 04-05-2022
271 Dian Eka Kurniawati, A.Md.Kep P Lamongan, 22/06/1983 D3 Keperawatan / 2005 PERAWAT Perawat mahir PNS 01/01/2010 P2T/15519/03.02/02/XI/2015 s/d 22/07/2020 395/SIPP/XI/2016 s/d 22/07/2020
272 Rini Widyastutik , A.Md.Kep P Lamongan, 16/02/1984 D3 Keperawatan / PERAWAT Perawat Kontrak 01/02/2008 P2T/3536/03.02/02/V/2016 s/d 16/02/2021 192/SIPP/VI/2016 s/d 16/02/2021
Pemda
273 Saufa Kusnayati, A.Md.Kep P lamongan, 8 agustus 1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8904/03.02/01/XII/2016 s/d 08-08-2021 283/SIPP/VII/2017 s/d 08-08-2021
274 Muh. Dimas Anang Bahari, A.Md.Kep L Lamongan, 19-8-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/9030/03.02/01/XII/2016 s/d 19-08-2021 646/SIPP/XI/2017 s/d 19-08-2021
275 Eka Indah Setiani, A.Md.Kep P Lamongan, 23-05-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/1871/03.02/02/IV/2019 s/d 23-05-2024 1653/SIPP.I/413.111/V/2019.P1 s/d 23-05-2024
276 Sus Erna Suryani, S.Kep, Ns P Sumenep, 19/02/1967 Ners / 2010 PERAWAT Perawat Madya PNS 01-03-1995 P2T/4376/03.03/02/VI/2016 s/d 19/02/2021 957/SIPP.I/413.111/III/2018.P1 s/d 19/02/2021
277 Gunawan Edy Sulistiyanto, S.Kep.Ners L Lamongan, 31/10/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01-04-2006 P27/5710/03.02/01/XI/2018 s/d 31/09/20123 292/SIPP/413.111/II/2019.P1 s/d 31/09/20123
278 Lilis Mamik,S.Kep.Ners P Lamongan, 14/11/1979 Ners / 2013 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/4340/30.02/01/VI/2016 s/d 14/11/2021 227/SIPP/VII/2016 s/d 14/11/2021
279 Ratna Watiningsih, A.Md.Kep P Lamongan, 13 -03-1983 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/797/03.02/02/II/2019 s/d 13/03/2024 711/SIPP.I/413.111/IV/2019.P1 s/d 13/03/2024
280 Karnadi, A.Md.Kep L Lamongan, 05/02/1978 Ners / 2014 PERAWAT Perawat Mahir PNS 01/01/2010 16 01 7 1 1 15-1039499 s/d 05-02-2020 384/SIPP/XI/2016 s/d 05-02-2020
281 Heffi Dwi Yulianti, A.Md.Kep P Lamongan, 08-07-1990 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2013 P2T/7630/03.02/02/XI/2016 s/d 08/07/2021 147/SIPP/IV/2017 s/d 08/07/2021
282 Sudarsono, A.Md.Kep L Lamongan, 29/09/1982 D3 Keperawatan / 2005 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/617/03.02/02/I/2016 s/d 29/09/2021 217/SIPP/VII/2016 s/d 29/09/2021
283 Ika Fiqiyati, A.Md.Kep P Lamongan, 15/09/1985 D3 Keperawatan / PERAWAT Perawat Kontrak 01/01/2010 P2T/5103/03.02/02/X/2018 s/d 15/09/2023 10/SIK.P/I/2014 s/d 15/09/2023
Pemda
284 Bangun Denny Setyawan, A.Md.Kep L Malang, 05-12-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7545/03.02/01/IX/2014 s/d 05-12-2019 212/SIPP/VIII/2016 s/d 05-12-2019
285 Hermi Astutik, S.Kep.Ns P Lamongan, 30-09-1985 Ners / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/403/03.02/01/I/2016 s/d 30/09/2021 226/SIPP/VII/2016 s/d 30/09/2021
286 Eka Yuliana Nur Anggraini, A.Md.Kep P Lamongan, 02-07-1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/11627/03.02/01/XI/2015 s/d 02-07-2020 384/SIPP/VIII/2017 s/d 02-07-2020
287 M. Syaiful Arif, A.Md.Kep L Lamongan, 23/10/1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 8/1/2018 P2T/7549/03.02/01/IX/2014 s/d 23/10/2019 2373/SIPP.I/413.111/VII/2018 s/d 23/10/2019
288 Ainun Mudliah, A.Md.Kep P Lamongan, 01/03/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/10/2018 P2T/640/03.02/01/I/2018 s/d 01/03/2023 2380/SIPP.I/413.111/VII/2018 s/d 01/03/2023
289 Ziar Rosa Kurniawati, A.md.Kep P Lamongan, 04/03/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/10/2018 P2T/281/03.02/01/I/2018 s/d 04/03/2023 2370/SIPP.I/413.111/VII/2018 s/d 04/03/2023
290 Fitri Zulyana, A.Md.Kep P Lamongan, 05/07/1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 8/1/2018 16 01 5 2 1 18-2245981 s/d 05/07/2023 3247/SIPP.I/413.111/IX/2018 s/d 05/07/2023
291 Umi Sa'adah, S.Kep.,Ns P Lamongan, 30/08/1969 Ners / 2011 PERAWAT Perawat Madya PNS 01-02-1989 P2T/6766/03.02/02/VII/2017 s/d 30/08/2022 708/SIPP/XII/2017 s/d 30/08/2022
292 Aan Masyruki, A.Md.Kep L Lamongan, 10-05-1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/08/2007 P2T/992/03.02/02/XI/2016 s/d 10/05/2021 562/SIPP/XII/2016 s/d 10/05/2021
293 Helmi Airlangga, A.Md.Kep L Lamongan, 25/10/1979 Ners / 2014 PERAWAT Perawat Pertama PNS 01-12-2003 16 01 7 1 1 15-1039498 s/d 25/10/2020 58/SIK.P/III/2015 s/d 25/10/2020
294 Afiyatur Rofiah, A.Md.Kep P Lamongan, 26-10-1986 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2009 P2T/7971/03.02/02/IX/2017 s/d 27-10-2022 701/SIPP/XII/2017 s/d 27-10-2022
295 Qurrota A'yun, A.Md.Kep P Lamongan, 01-10-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/5116/03.02/02/X/2018 s/d 01/10/2023 4041/SIPP.I/413.111/XII/2018.P1 s/d 01/10/2023

296 Akhmad Safari Fajjri, S.Kep.Ns L Sumenep, 08-10-1987 Ners / PERAWAT Perawat Kontrak BLUD 01/06/2015 P2T/7986/03.02/01/IX/2017 s/d 08-10-2022 702/SIPP/XII/2017 s/d 08-10-2022
297 Anis Yuli Setyowati, A.Md.Kep P Lamongan, 26 -07-1981 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/2702/03.02/02/VII/2019 s/d 26/07/2024 2110/SIPP.I/413.111/VII/2019.P1 s/d 26/07/2024

298 Benny Candra Topan, S.Kep.Ners L Lamongan, 04/01/1987 Ners / 2014 PERAWAT Perawat Mahir PNS 01/02/2009 P2T/6940/03.02/01/VIII/2017 s/d 04/01/2022 503/SIPP/IX/2017 s/d 04/01/2022
299 Vidi Nurtama, A.Md.Kep L Lamongan, 30-06-1988 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2012 P2T/7565/03.02/01/VII/2015 s/d 30/07/2020 238/SIPP/VII/2016 s/d 30/07/2020
300 Imam Bukhori, A.Md.Kep L Lamongan, 03/07/1983 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/6863/03.02/02/X/2016 s/d 03-07-2021 152/SIPP/IV/2017 s/d 03-07-2021
301 Mardiyah Purwatiningsih, A.Md.Kep P Lamongan, 03-04-1981 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/3443/03.02/02/VII/2018 s/d 03-04-2023 3659/SIPP.I/413.111/XI/2018.P1 s/d 03-04-2023
302 Nur Kholifah, A.Md.Kep P Lamongan, 24-06-1985 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/6861/03.02/02/X/2016 s/d 24-06-2021 149/SIPP/IV/2017 s/d 24-06-2021
303 Pitra Sari Mahatmi, A.Md.Kep P Lamongan, 14/07/1986 D3 Keperawatan / PERAWAT Perawat Kontrak 01/07/2008 P2T/9067/03.02/02/XI/2017 s/d 14/06/2022 648/SIPP/XII/2017 s/d 14/06/2022
Pemda
304 Siti Umaiyyah, A.Md.Kep P Lamongan, 11/05/1981 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/355/03.02/01/I/2015 s/d 11-05-2020 59/SIK.P/III/2015 s/d 11-05-2020
305 Titik Nurhidayati, A.Md.Kep P Lamongan, 17/12/1982 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/114/03.02/01/I/2015 s/d 17/12-2020 240/SIPP/VII/2016 s/d 17/12-2020
306 Vivin Frank Land Man, A.Md.Kep L Lamongan, 20-02-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2007 P2T/618/03.02/02/I/2016 s/d 20/02/2021 151/SIPP/IV/2017 s/d 20/02/2021
307 Anreka Yudha Timor, A.Md.Kep L Lamongan, 21-1-1984 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/519/03.02/01/I/2017 s/d 21-11-2022 602/SIPP/XI/2017 s/d 21-11-2022
308 Sri Wahyuni, A.Md.Kep P Lamongan, 23 juli 1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/11678/03.02/01/XI/2015 s/d 23-07-2020 605/SIPP/XI/2017 s/d 23-07-2020
309 Ighna Masfiatun Afifah, A.Md.Kep P Lamongan, 12-07-1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 12 01 5 2 1 16-2002332 s/d 28-06-2021 607/SIPP/XI/2017 s/d 28-06-2021
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
310 Riska Puji Lestari, A.Md.Kep P Lamongan, 14-09-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8879/03.02/01/XII/2016 s/d 14-09-2021 603/SIPP/XI/2017 s/d 14-09-2021
311 Agung Purnomo, A.Md.Kep L Lamongan, 6 oktober 1990 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/7977/03.02/02/IX/2017 s/d 04-10-2022 608/SIPP/XI/2017 s/d 04-10-2022
312 Nur Lia Anggraini, A.Md.Kep P Lamongan, 04-01-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8678/03.02/01/XI/2016 s/d 04/01/2021 606/SIPP/XI/2017 s/d 04/01/2021
313 Hevi Eka Candra Febrianti, A.Md.Kep P Lamongan, 29 februari 1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8804/03.02/01/XI/2016 s/d 29-02-2021 604/SIPP/XI/2017 s/d 29-02-2021

314 Iva Wahyuningsih, A.Md.Kep P Lamongan, 08/06/1981 D3 Keperawatan / 2002 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/9071/03.02/02/XI/2017 s/d 08-06-2022 625/SIPP/XI/2017 s/d 08-06-2022
315 Ni’matus Sa’diyah, A.Md.Kep P Lamongan, 11/04/1989 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/433/03.02/02/I/2015 s/d 11/04/2020 204/SIPP/VI/2016 s/d 11/04/2020
316 Yeti Arvika Rini, A.Md.Kep P Lamongan, 26 oktober 1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/11620/03.02/01/XI/2015 s/d 26-10-2020 589/SIPP/XI/2017 s/d 26-10-2020

317 Rahardian Dias Perdana, A.Md.Kep L Lamongan, 23 desember D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 160151118-2391380 s/d 23-12-2023 1975/SIP.I/413.111/VII/2019.P1 s/d 23-12-2023
1991
318 Rosita, A.Md.Kep P Lamongan, 22 desember D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8921/03.02/01/XII/2016 s/d 22-12-2021 324/SIPP/VIII/2017 s/d 22-12-2021
1994
319 Alwanul Ulum, A.Md.Kep L Lamongan, 09-08-1989 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2013 P2T/8632/03.02/02/X/2017 s/d 03-08-2022 724/SIPP/VIII/2017 s/d 03-08-2022
320 M. Iltizamul khoiri, A.Md.Kep L Lamongan, 19-11-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2015 160151118-2390358 s/d 19-11-2023 1988/SIP.I/413.111/VII/2019.P1 s/d 19-11-2023
321 Jeni Meldiati, A.Md.Kep P Lamongan, 07-04-1986 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2012 P2T/2839/03.02/02/IV/2018 s/d 07/04/2023 2236/SIPP.I/413.111/VI/2018.P1 s/d 07/04/2023
322 Abdul Ghoni Azmi, S.Kep.Ners L Lamongan, 7 juli 1993 Ners / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/8437/03.02/01/XI/2016 s/d 07/07/2021 277/SIPP/VII/2017 s/d 07/07/2021
323 Moch. Rizki Alfan Tinno, A.Md.Kep L Lamongan, 17 september D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/05/2017 P2T/12766/03.02/01/XI/2015 s/d 17-09-2020 332/SIPP/VIII/2017 s/d 17-09-2020
1994
324 Subadi, S.Kep.Ners L Lamongan, 04/07/1969 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1991 16 01 7 1 1 15-0978082 s/d 04/07/2020 3460/SIPP.I/314.111/X/2018.P1 s/d 04/07/2020
325 Ach Na’im, S.Kep.Ners L Lamongan, 17/08/1974 Ners / 2014 PERAWAT Perawat Muda PNS 01/03/1996 P2T/6794/03.02/01/V/2015 s/d 27/08/2020 431/SIPP/XXI/2016 s/d 27/08/2020
326 Choirun Niswatin, A.Md.Kep P Lamongan, 20/10/1985 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/78372/03.02/02/X/2017 s/d 20/10/2022 545/SIPP/X/2017 s/d 20/10/2022
327 Kartono, S.Kep.Ners L Lamongan, 16/11/1972 Ners / 2014 PERAWAT Perawat Mahir PNS 01/03/1997 16 01 7 1 1 15-0978067 s/d 16/11/2020 432/SIPP/XI/2016 s/d 16/11/2020
328 Nita Dewi Indayani, A.Md.Kep P Lamongan, 16/11/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/1981/03.02/01/II/2011 s/d 16/11/2022 94/SIPP/III/2017 s/d 16/11/2022
329 Riri Kusuma Wati, A.Md.Kep P Lamongan, 08/02/1987 D3 Keperawatan / 2007 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/2008/03.02/02/II/2016 s/d 06/02/2021 430/SIPP/XI/2016 s/d 06/02/2021
330 Umi Sa’adah, S.Kep.Ners P Sidoarjo, 09/11/1976 Ners / 2016 PERAWAT Perawat Penyelia PNS 01-12-2000 P2T/1649/03.02/01/II/2017 s/d 09/11/2022 95/SIPP/III/2017 s/d 09/11/2022
331 Sigit Ardiawan, S.Kep.Ners L Lamongan, 22/10/1981 Ners / 2016 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/6769/03.02/01/VII/2017 s/d 22-10-2020 502/SIPP/IX/2017 s/d 22-10-2020
332 Alimatus Sa'diyah, A.Md.Kep P Lamongan, 21-06-1992 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2014 P2T/4057/03.02/02/VIII/2018 s/d 21/06/2023 3459/SIPP.I/413.111/X/2018.P1 s/d 21/06/2023
333 Anang Heru K, A.Md.Kep L Lamongan, 17-06-1983 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2008 P2T/911/03.02/02/I/2014 s/d 07/06/2019 32/SIK.P/I/2014 s/d 07/06/2019
334 Su'ib, S.Kep.Ners L Gresik, 28/07/1969 Ners / 2012 PERAWAT Perawat Madya PNS 01/02/1990 P2T/3998/03.02/02/VIII/2018 s/d 28/07/2023 3658/SIPP.I/413.111/XI/2018.P1 s/d 28/07/2023
335 Nur Lely Idayanti, A.Md.Kep P Lamongan, 22/06/1979 Ners / 2013 PERAWAT Perawat Pertama PNS 01-04-2006 P2T/2056/03.02/02/V/2019 s/d 22-06-2024 2168/SIPP.I/413.111/VIII/2019.P1 s/d 22-06-2024

336 Dina Kurnia Rahayu, A.Md.Kep P Lamongan, 20 -04- 1982 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/03/2007 P2T/3537/03.02/02/V/2016 s/d 20/04/2021 189/SIPP/VI/2016 s/d 20/04/2021
337 Sukhimeiyarsih, S.Kep.Ners P Lamonngan, 25/05/1969 Ners / 2014 PERAWAT Perawat Muda PNS 01-03-1991 16 01 7 2 1 15-1039503 s/d 22-05-2020 2028/SIPP.I/413.111/V/2018.P1 s/d 22-05-2020
338 Giyani, S.Kep.Ners P Sragen, 31/08/1976 Ners / 2013 PERAWAT Perawat Pertama PNS 01-12-2003 P2T/1941/03.02/02/VII/2019 s/d 31-08-2024 2291/SIPP.I/413.111/VIII/2019.P1 s/d 31-08-2024

339 Yasin, A.Md.Kep L Lamongan, 22/03/1965 D3 Keperawatan / 2000 PERAWAT Perawat Penyelia PNS 01-03-1989 P2T/2193/03.02/02/III/2018 s/d 22/03/2023 2375/SIPP/I/413.111/VII/2018.P1 s/d 22/03/2023

340 Wahyu Suprihatin, A.Md.Kep P Lamongan, 15/03/1981 D3 Keperawatan / 2002 PERAWAT Perawat Penyelia PNS 01-03-2003 P27/798/03.02/02/II/2019 s/d 15-03-2024 2167/SIPP.I/413.111/VIII/2019.P1 s/d 15-03-2024

341 Sunarjo, S.Kep, Ns L Lamongan, 16/04/1976 Ners / 2013 PERAWAT Perawat Muda PNS 01-03-1997 P2T/2383/03.02/01/II/2017 s/d 16/04/2022 217/SIPP/VIII/2017 s/d 16/04/2022
342 A. Muhajir, S.Kep.Ners L Lamongan, 07/07/1965 Ners / 2011 PERAWAT Perawat Madya PNS 01/03/1989 P2T/5208/03.02/02/VI/2017 s/d 17/07/2022 3.684/SIPP.I/413.111/XI/2018.P1 s/d 17/07/2022

343 Marno, A.Md.Kep L Lamongan, 13/04/1965 D3 Keperawatan / 2009 PERAWAT Perawat Penyelia PNS 01/03/1991 P2T/803/03.02/02/II/2019 s/d 13/04/2024 567/SIPP.I/413.111/III/2019.P1 s/d 13/04/2024
344 Nur Isworo, S.Kep.Ns L Lamongan, 04/10/1975 Ners / 2013 PERAWAT Perawat Muda PNS 01/03/1997 P2T/1968/03.02/01/II/2014 s/d 04-10-2019 200/SIK.P/V/2014 s/d 04-10-2019
345 Ristunik, S.Kep.Ners P Malang, 19/11/1968 Ners / 2014 PERAWAT Perawat Madya PNS 01-12-1994 16 01 7 2 1 15-1039502 s/d 19/11/2020 3656/SIPP.I/413.111/XI/2018/P1 s/d 19/11/2020

346 Arum Sulistyowati, s.Kep.Ners P Lamongan, 27/08/1980 Ners / 2016 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/8769/03.02/01/X/2017 s/d 27/08/2020 647/SIPP/XII/2017 s/d 27/08/2020
347 Uslan, A.Md.Kep L Lamongan, 27/01/1972 Ners / 2013 PERAWAT Perawat Penyelia PNS 01/03/1994 P2T/25114/03.02/01/III/2015 s/d 27/01/2020 503/SIPP/XII/2016 s/d 27/01/2020
348 Lewy Andria, A.Md.Kep P Bojonegoro, 29/08/1978 D3 Keperawatan / 2000 PERAWAT Perawat Mahir PNS 01-04-2006 P2T/429/03.02/01/I/2015 s/d 20-08-2020 61/SIK.P/III/2015 s/d 20-08-2020
349 M. Hasyim.B, A.Md.Kep L Gresik, 13/04/1962 D3 Keperawatan / 2005 PERAWAT Perawat Penyelia PNS 01-12-1984 P2T/5129/03.02/02/VIII/2016 s/d 13/04/2021 262/SIPP/VIII/2016 s/d 13/04/2021
350 Erna Rokhmawati, A.Md.Kep P Lamongan, 22/07/1985 D3 Keperawatan / 2008 PERAWAT Perawat Mahir PNS 01/01/2011 P2T/7717/03.02/02/XI/2016 s/d 28/07/2021 533/SIPP/X/2017 s/d 28/07/2021
NO NAMA JENIS TEMPAT DAN TANGGAL PENDIDIKAN TERAKHIR PEKERJAAN JABATAN STATUS DIANGKAT TMT STR SIP/ SIK KETERANGAN
KELAMIN LAHIR TENAGA

1 2 3 4 5 6 7 8 9 10 11 12
351 Kasmulin, S.Kep.Ns L Lamongan, 04/06/1967 Ners / 2014 PERAWAT Perawat Madya PNS 01-03-1989 P2T/7175/03.02/01/VIII/2017 s/d 04/06/2022 567/SIPP/X/2017 s/d 04/06/2022
352 Andik Winarno, A.Md L Lamongan, 23/04/1980 D3 Kes Gigi / 2011 PERAWAT Perawat Gigi PNS 01/04/2006 16 04 5 1 1 17-2095275 s/d 23/04/2022 4092/SIPTGM/413.111/XII/2018.P1 s/d
Pelaksana 23/04/2022
353 Sugianto L Lamongan, 30/01/1969 SPK / 1988 PERAWAT Perawat Penyelia PNS 01-03-1989 P2T/1985/03.02/02/III/2018 s/d 17/10/2020 3484/SIPP.I/413.111/X/2018.P1 s/d 17/10/2020
354 Mochamad Rochim, A.Md.Kep L Lamongan, 12/10/1977 Ners / 2016 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/2024/03.02/01/II/2017 s/d 12/10/2022 105/SIPP/III/2017 s/d 12/10/2022
355 Endang Sukeniati, A.Md.Kep P Lamongan, 26/05/1964 D3 Keperawatan / 2000 PERAWAT Perawat Penyelia PNS 01/03/1987 P2T/16622/03.02/01/XII/2015 s/d 26/05/2020 433/SIPP/XI/2016 s/d 26/05/2020
356 Suhaji, S.Kep, Ns L Lamongan, 01/08/1966 Ners / 2011 PERAWAT Perawat Muda PNS 01/03/1985 P2T/6767/03.02/02/VII/2017 s/d 01/08/2022 316/SIPP/VIII/2017 s/d 01/08/2022
357 Lilik Suryani, A.Md.Kep P Lamongan, 22/03/1967 D3 Keperawatan / 2005 PERAWAT Perawat Penyelia PNS 01/01/1988 P2T/2392/03.02/02/III/2018 s/d 22/03/2023 2716/SIPP.I/413.111/VII/2018.P1 s/d 22/03/2023

358 Hartini, S.Kep.Ners P Lamongan, 26/02/1981 Ners / 2013 PERAWAT Perawat Pertama PNS 01/04/2006 P2T/512/03.02/02/II/2019 s/d 26/02/2024 536/SIPP.I/413.111/III/2019.P1 s/d 26/02/2024
359 Mardi, A.Md.Kep L Lamongan, 02/09/1966 D3 Keperawatan / 2018 PERAWAT Perawat Penyelia PNS 08-08-2008 16 01 5 1 1 18-1582665 s/d 02/09/2023 290/SIPP.I/413.111/II/2019.P1 s/d 02/09/2023
360 Imam Kanafi, S.Kep.Ners L Lamongan, 26/05/1973 Ners / 2013 PERAWAT Perawat Penyelia PNS 01/03/1995 P2T/1975/03.02/01/II/2014 s/d 26/05/2019 2791/SIPP.I/314.111/VII/2018.P1 s/d 26/05/2019

361 Genduk Linah P Lamongan, 07/04/1981 PERAWAT Perawat Kontrak 01/01/2008 P2T/3535/03.02/V/2016 s/d 17-10-2020 188/SIPP/VI/2016 s/d 17-10-2020
Pemda
362 Sumarji, A.Md.Kep L Lamongan, 04/06/1973 Ners / 2014 PERAWAT Perawat Muda PNS 01/03/1994 16 01 7 1 1 18-1551910 s/d 04-06-2023 3916/SIPP.I/413.111/III/2018.P1 s/d 04-06-2023
363 Dwi Mei Karyanti, A.Md.Kep P Lamongan, 02/05/1977 Ners / 2014 PERAWAT Perawat Mahir PNS 01-12-2003 P2T/11023/03.02/02/XII/2014 s/d 02/05/2019 201/SIK.P/VII/2015 s/d 02/05/2019
364 Suwito, S.Kep, Ns L Lamongan, 14/10/1969 Ners / 2011 PERAWAT Perawat Madya PNS 01-02-1990 P2T/7255/03.02/02/VIII/2017 s/d 14/10/2022 420/SIPP/VIII/2017 s/d 14/10/2022
365 Ach. Marzuki, A.Md.Kep L Lamongan, 12/07/1969 Ners / 2014 PERAWAT Perawat Muda PNS 01/03/1997 16 01 7 1 1 15-1039496 s/d 12-07-2020 82/SIPP/II/2017 s/d 12-07-2020
366 Haria Sidiana, A.Md.Kep P Lamongan, 09/10/1981 D3 Keperawatan / 2003 PERAWAT Perawat Mahir PNS 01/04/2006 P2T/354/03.02/01/I/2015 s/d 09-10-2020 60/SIK.P/III/2015 s/d 09-10-2020
367 Tutut Supiatun, A.Md.Kep P Lamongan,05/12/1982 D3 Keperawatan / 2004 PERAWAT Perawat Mahir PNS 01/01/2010 P2T/5781/03.02/02/XII/2018 s/d 05-12-2023 245/SIK.P/VIII/2013 s/d 05-12-2023
368 Syahrizal Hakim, S.Kep.Ners L Lamongan, 12-02-1993 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8436/03.02/01/XI/2016 s/d 12/02/2021 1652/SIPP.I/413.111/V/2019 s/d 12/02/2021
369 Dwi Vita Febriyanti, S.Kep.Ners P Lamongan,13-02-1989 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 160172116-1117134 s/d 13/02/2021 1822/SIPP.I/413.111/VI/2019 s/d 13/02/2021
370 Ummu Khabibah, S.Kep.Ners P Lamongan, 15-07-1994 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 160172118-2245503 s/d 15/07/2023 1824/SIPP.I/413.111/VI/2019 s/d 15/07/2023
371 Kefi ‘Afiyah, A.Md.Kep P Lamongan, 17-04-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8880/03.02/02/XII/2016 s/d 14/12/2021 1829/SIPP.I/413.111/VI/2019 s/d 14/12/2021
372 Deni Fariyanti, A.Md.Kep P Lamongan, 23-04-1997 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/447/03.02/01/II/2019 s/d 23/04/2024 1773/SIPP.I/413.111/VI/2019 s/d 23/04/2024
373 Warokhmah Feriana Sari, A.Md.Kep P Lamongan, 25-02-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8684/03.02/01/XI/2016 s/d 25/02/2021 1649/SIPP.I/413.111/V/2019 s/d 25/02/2021
374 Mia Dwi Wahyu Anggraeny, A.Md.Kep P Lamongan, 25-05-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/9982/03.02/01/XII/2017 s/d 25/05/2022 1774/SIPP.I/413.111/VI/2019 s/d 25/05/2022
375 Mar’atus Solikhah, A.Md.Kep P Lamongan, 1-10-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/11504/03.02/01/X/2015 s/d 01/10/2020 1830/SIPP.I/413.111/VI/2019 s/d 01/10/2020
376 Ayu Nova Safitri, A.Md.Kep P Lamongan, 01-05-1993 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/885/03.02/01/I/2018 s/d 01/05/2023 1825/SIPP.I/413.111/VI/2019 s/d 01/05/2023
377 Catur Sugiharto, S.Kep.Ners L Bojonegoro, 15-06-1993 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8399/03.02/01/XI/2016 s/d 15/06/2021 1826/SIPP.I/413.111/VI/2019 s/d 15/06/2021
378 Benny Caesaria Ummah, S.Kep.Ners L Lamongan, 10/09/1991 Ners / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/3261/03.02/01/VI/2016 s/d 10/09/2023 1645/SIPP.I/413.111/V/2019 s/d 10/09/2023
379 Imam Nur Aziz, S.Kep.Ners L Lamongan, 30/03/1992 Ners / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/4763/03.02/01/V/2017 s/d 30/03/2022 1651/SIPP.I/413.111/V/2019 s/d 30/03/2022
380 Achmad Fanani Aprilianto, A.md.Kep L Lamongan, 27 april 1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/275/03.02/01/I/2019 s/d 27/04/2023 1141/SIPP.I/413.111/V/2019 s/d 27/04/2023
381 Rachmat Yayan Gunarto, A.md.Kep L Lamongan, 11/08/1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/742/03.02/02/II/2017 s/d 11/08/2024 1650/SIPP.I/413.111/V/2019 s/d 11/08/2024
382 Fajri Maudhukha, A.Md.Kep P Lamongan, 23 Mei 1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/6108/03.02/02/VII/2017 s/d 23/05/2022 1647/SIPP.I/413.111/V/2019 s/d 23/05/2022
383 Dwi Nanda Wibowo, A.Md.Kep L Lamongan, 12 Januari 1991 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/2099/03.02/02/II/2017 s/d 12/01/2022 1646/SIPP.I/413.111/V/2019 s/d 12/01/2022
384 Siska Dwi Nuringtias, A.Md.Kep P Lamongan, 13 Januari 1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/8919/03.02/01/XII/2016 s/d 13/01/2021 1823/SIPP.I/413.111/VI/2019 s/d 13/01/2021
385 Devi Adilah Kurnia Sari, A.Md.Kep P Lamongan, 30/06/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/10103/03.02/01/XII/2017 s/d 30/06/2022 1644/SIPP.I/413.111/V/2019 s/d 30/06/2022
386 Yogi Pratama Putra, A.Md.Kep L Lamongan, 12/07/1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/02/2019 P2T/8791/03.02/01/XI/2018 s/d 12/07/2021 1648/SIPP.I/413.111/V/2019 s/d 12/07/2021
387 Evy Eka Indriyanti, A.Md.Kep P Gresik, 21/12/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 160152118-1596300 s/d 21/12/2023 1649/SIPP.I/413.111/V/2019 s/d 21/12/2023
388 Viva Ronica Puspita Handayani, A.Md.Kep P Lamongan, 07/01/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/1449/03.02/01/II/2018 s/d 07/01/2021 2253/SIPP.I/413.111/VIII/2019 s/d 07/01/2021
389 Nur Latifah Fitriyanti, A.Md.Kep P Lamongan, 19/02/1996 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/16/03.02/01/I/2018 s/d 19/02/2023 2250/SIPP.I/413.111/VIII/2019 s/d 19/02/2023
390 Titin Hardiyanti, A.Md.Kep P Lamongan, 12/05/1997 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/120/03.02/01/I/2019 s/d 12/05/2024 2255/SIPP.I/413.111/VIII/2019 s/d 12/05/2024
391 Siti Rohmawati A.Md.Kep P Lamongan, 23/11/1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/9986/03.02/01/XII/2017 s/d 23/11/2022 2254/SIPP.I/413.111/VIII/2019 s/d 23/11/2022
392 Nur Azizah, A.Md.Kep P Lamongan, 15/10/1994 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/06/2019 P2T/9318/03.02/01/XII/2016 s/d 15/10/2021 2248/SIPP.I/413.111/VIII/2019 s/d 15/10/2021
393 Dina Hidayatul Aminah, A.Md.Kep P Lamongan, 24-12-1995 D3 Keperawatan / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/8891/03.03/01/XII/2016 s/d 24/12/2021 1771/SIPP.I/413.111/VI/2019 s/d 24/12/2021
394 Weni Agustina, S.Kep.Ners P Wonogiri, 30-08-1991 Ners / PERAWAT Perawat Kontrak BLUD 01/04/2019 P2T/10737/03.02/01/X/2015 s/d 30/08/2020 1827/SIPP.I/413.111/VI/2019 s/d 30/08/2020
NO NAMA JENIS KELAMIN TEMPAT DAN T PENDIDIKAN PEKERJAAN JABATAN
1 2 3 4 5 6 7
DATA PERSONIL UNIT KERJA :
RUMAH SAKIT XXXX
STATUS TENAGA DIANGKAT TMT UNIT KERJA IJAZAH STR SIP/ SIK
8 9 10 11 12 13
SERTIFIKAT PELATIHAN SPK RKK KETERANGAN
14

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