MS. ADRIENNE J MAYNARD (NPI# 1063559094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063559094 |
| Entity Type | Individual |
| Full Name | MS. ADRIENNE J MAYNARD |
| Credential | DNP, PMHNP BC |
| Practice Address |
1245 Edgewater St Nw Salem OR 97304-4049 |
| Practice Telephone | 5035885816 |
| Practice Fax Number | 5035885803 |
| Mailing Telephone | 5035885816 |
| Mailing Fax Number | 5035885803 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2011-11-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
200850148NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
09248 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1245 EDGEWATER ST NW |
| City | SALEM |
| State | OR |
| Zip Code | 97304-4049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609957356 | Susan Barnes | Student in an Organized Health Care Education/Training Program | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2006-10-18 |
| 1225671910 | Summer Joy Valentine | Student in an Organized Health Care Education/Training Program | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2019-10-24 |
| 1346895075 | Anne Elizabeth Wagner | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2019-08-08 |
| 1992273718 | Marc R Malone | Psychologist | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2018-11-09 |
| 1043704554 | Erin Melissa Cox | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2018-06-18 |
| 1386167732 | Julie Marie O'connor | Social Worker | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2017-07-18 |
| 1366892408 | Miranda Featherstone | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2016-06-20 |
| 1518334028 | Ryan Matthew Gunter | Physician Assistant | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2015-09-01 |
| 1073903977 | Gerardo Jimenez | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2015-01-29 |
| 1265822167 | Ivan Gutierrez | Counselor | 1245 Edgewater St Nw, Salem, OR 97304-4049 | 2015-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1033428198 | Kathleen Ketelson | Nurse Practitioner | 560 Wallace Rd Nw Ste 140, Salem, OR 97304 | 2010-10-06 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073421 | Aspire Telepsychiatry | Nurse Practitioner | 1910 24th St Ne, Salem, OR 97301-8150 | 2020-01-28 |
| 1962058362 | Kimberly Diane Nelson | Nurse Practitioner | 35 Congress St Ste 225, Salem, MA 01970-5529 | 2019-08-13 |
| 1861970972 | Norrine Mcnelley | Nurse Practitioner | 25 Beechwood Rd, Salem, NH 03079 | 2018-07-31 |
| 1235493495 | Sarah Frances Robbins | Nurse Practitioner | 1595 Roosevelt St Ne, Salem, OR 97301 | 2012-07-02 |
| 1700155538 | Vanessa Anne Underwood | Nurse Practitioner | 1595 Cottage St Ne, Salem, OR 97301-7123 | 2011-12-22 |
| 1134364524 | Sharon Vaden Karn | Nurse Practitioner | 870 Commercial St Se, Salem, OR 97302-4108 | 2008-12-12 |
| 1861605768 | Barbara S Miller | Nurse Practitioner | Odoc, 2605 State St, Salem, OR 97310-0001 | 2007-05-07 |
| 1538225818 | Aleyna Cecile Reed | Nurse Practitioner | 685 Cottage St Ne, Salem, OR 97301-2419 | 2006-12-29 |
| 1407915408 | James Ben Newman | Nurse Practitioner | 1235 Woodrow St Ne, Salem, OR 97303-3214 | 2006-12-06 |
| 1033285713 | Rita Herlong | Nurse Practitioner | 4035 12th Street Cutoff, Suit120, Salem, OR 97302-1764 | 2006-11-27 |
| Find all providers in SALEM | ||||
Please comment or provide details below to improve the information on MS. ADRIENNE J MAYNARD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.