TIFFANY BRACKUS (NPI# 1194336339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194336339 |
| Entity Type | Individual |
| Full Name | TIFFANY BRACKUS |
| Credential | FNP |
| Practice Address |
790 E 5th St Coquille OR 97423-1755 |
| Practice Telephone | 5413963111 |
| Practice Fax Number | 5413965891 |
| Mailing Telephone | 5413963111 |
| Mailing Fax Number | 5419365891 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
202009819NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
TEMP65467 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
790 E 5TH ST |
| City | COQUILLE |
| State | OR |
| Zip Code | 97423-1755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063496602 | Nancy Keller | Family Medicine | 790 E 5th St, Coquille, OR 97423-1755 | 2005-12-06 |
| 1578189601 | Vanessa Noreen Mohrbacher | Nurse Practitioner | 790 E 5th St, Coquille, OR 97423-1755 | 2020-06-24 |
| 1164082988 | Amanda Krantz | Registered Nurse | 790 E 5th St, Coquille, OR 97423-1755 | 2019-06-14 |
| 1699276287 | Adam Clark | Social Worker | 790 E 5th St, Coquille, OR 97423-1755 | 2018-02-28 |
| 1861945487 | Julian Andres Ospina | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2016-07-31 |
| 1326428475 | Kriti Choudhary | Family Medicine | 790 E 5th St, Coquille, OR 97423 | 2015-06-04 |
| 1215356381 | Malissa Trojan | Social Worker | 790 E 5th St, Coquille, OR 97423-1755 | 2014-04-15 |
| 1538424346 | Paavani Atluri | Internal Medicine | 790 E 5th St, Coquille, OR 97423 | 2012-07-08 |
| 1265758973 | Brock W. Millet | Family Medicine | 790 E 5th St, Coquille, OR 97423-1755 | 2010-04-20 |
| 1083749394 | Susan K Sinnott | Marriage & Family Therapist | 790 E 5th St, Coquille, OR 97423-1755 | 2007-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457919003 | Julie Ann Hage | Registered Nurse | 306s Irving, Coquile, OR 97423 | 2019-05-30 |
| 1730417106 | Pahls Dentistry PC | Dentist | 346 N. Central Blvd, Coquille, OR 97423 | 2009-11-24 |
| 1730223967 | Coquille Valley Hospital District | General Acute Care Hospital | 940 East Fifth Street, Coquille, OR 97423 | 2007-02-19 |
| 1942366687 | Douglas Deverne Day | Dentist | 346 N Central, Coquille, OR 97423 | 2006-12-28 |
| 1417040023 | County of Coos Coos County School District R8 | Local Education Agency (LEA) | 790 W 17th St, Coquille, OR 97423 | 2006-10-02 |
| 1689650673 | Douglas Gordon Crane | Internal Medicine | 940 East Fifth Street East Wing, Coquille, OR 97423 | 2005-12-21 |
| 1164557179 | Coquille Valley Hospital District | Medicare Defined Swing Bed Unit | 940 E 5th St, Coquille, OR 97423 | 2007-02-22 |
| 1962824060 | Oregon Retina, LLP | Ophthalmology | 855 W Central Blvd, Coquille, OR 97423-1095 | 2014-01-09 |
| 1356594162 | Rebecca Marie Crawford | Case Manager/Care Coordinator | 585 W 4th Pl, Coquille, OR 97423-1150 | 2008-10-24 |
| 1073758389 | Glenda Gay Balneg | Physical Therapist | 279 N Central Blvd, Coquille, OR 97423-1241 | 2008-12-16 |
| Find all providers in zip 97423 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407810658 | Juli Schurmann | Nurse Practitioner | 940 E 5th St, Coquille, OR 97423-1666 | 2006-04-14 |
| 1578189601 | Vanessa Noreen Mohrbacher | Nurse Practitioner | 790 E 5th St, Coquille, OR 97423-1755 | 2020-06-24 |
| 1588061048 | Felisha Miller | Nurse Practitioner | 940 E 5th St, Coquille, OR 97423-1666 | 2014-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484631 | Dana Marie Hampton | Nurse Practitioner | 2474 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2020-10-13 |
| 1730796525 | Eden Fair | Nurse Practitioner | 841 E Cascade Ave, Sisters, OR 97759-5014 | 2020-09-25 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1548870306 | Virtual Recovery | Nurse Practitioner | 1038 Heathrow Dr, Eugene, OR 97402-1585 | 2020-08-06 |
| 1174148969 | Martina D Ford | Nurse Practitioner | 9370 Sw Greenburg Rd Ste 200, Tigard, OR 97223-5421 | 2020-06-08 |
| 1134740152 | South Coast Healthcare LLC | Nurse Practitioner | 29641 Ellensburg Ave, Gold Beach, OR 97444-8701 | 2020-04-30 |
| 1124657887 | Shelly Prather | Nurse Practitioner | 350 Wheeler St, Lebanon, OR 97355-4349 | 2020-04-05 |
| 1811521586 | Valorine Tsopmoh Tsopmoh | Nurse Practitioner | 924 Se Sacha Pl, Hillsboro, OR 97123-4685 | 2020-03-02 |
| 1174163356 | Erika Nichole Adams | Nurse Practitioner | 180 Ford Rd., John Day, OR 97845 | 2020-01-15 |
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| Find all providers with the same taxonomy | ||||
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| 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.