MISTY ANGELIQUE ROETZEL (NPI# 1295131399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295131399 |
| Entity Type | Individual |
| Full Name | MISTY ANGELIQUE ROETZEL |
| Practice Address |
2227 W Main St Suite 3 Jacksonville AR 72076-4207 |
| Mailing Address |
1802 Green Acres Rd Jacksonville AR 72076-2803 |
| Practice Telephone | 5019859944 |
| Practice Fax Number | 5019856590 |
| Mailing Telephone | 5019859944 |
| Mailing Fax Number | 5019856590 |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2227 W MAIN ST SUITE 3 |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076-4207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609976885 | Reginnia Marie Christian | Specialist/Technologist | 2227 W Main St, Jacksonville, AR 72076 | 2006-09-25 |
| 1144768235 | Lori G Main | Technician, Other | 2227 W Main St, Suite 3, Jacksonville, AR 72076-4207 | 2017-02-08 |
| 1447596648 | Christopher Douglas Bratton | Technician, Other | 2227 W Main St, Jacksonville, AR 72076-4207 | 2012-12-17 |
| 1407190234 | Candince Chimera Hodges | Technician, Other | 2227 W Main St, Ste #3, Jacksonville, AR 72076-4207 | 2012-11-16 |
| 1376892919 | Hollie Plummer | Technician, Other | 2227 W Main St, Jacksonville, AR 72076-4207 | 2012-08-29 |
| 1215282108 | Rachel Marie Robertson | Technician, Other | 2227 W Main St, Jacksonville, AR 72076-4207 | 2012-07-17 |
| 1841555778 | Jennifer M Saxton | Technician, Other | 2227 W Main St, Jacksonville, AR 72076-4207 | 2012-07-06 |
| 1235320235 | Juliana Brook Davis | Specialist/Technologist | 2227 W Main St, Ste 3, Jacksonville, AR 72076-4207 | 2007-08-05 |
| 1922178060 | Doctors Testing Center LLC II | Family Medicine | 2227 W Main St, Suite 4, Jacksonville, AR 72076-4207 | 2006-11-08 |
| 1396845574 | Ronald F Davis | Specialist/Technologist | 2227 W Main St, Jacksonville, AR 72076-4207 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1912464009 | Stat Home Health - Cenark LLC | Home Health | 1410 Braden Street, Jacksonville, AR 72076 | 2019-02-25 |
| 1649797671 | Caring Hearts Counseling, LLC | Case Management | 111 Marble Drive, Jacksonville, AR 72076 | 2017-08-30 |
| 1376071340 | Anne Elizabeth Houtchens | Speech-Language Pathologist | 2701 Tp White Drive, Jacksonville, AR 72076 | 2017-06-02 |
| 1881140648 | Jacksonville North Pulaski School District | Local Education Agency (LEA) | 1414 West Main, Jacksonville, AR 72076 | 2016-08-31 |
| 1134599772 | Jeremiah Melson Fleeman | Occupational Therapist | 2701 Tpwhite Drive, Jacksonville, AR 72076 | 2015-09-25 |
| 1821424565 | Kasey Michele Leeson | Social Worker | 2520 W. Main St., Jacksonville, AR 72076 | 2013-09-25 |
| 1407104052 | Cesalie Deonne Wallace | Nurse Practitioner | 3000 North First Street, Jacksonville, AR 72076 | 2012-08-29 |
| 1952660995 | Joshua Aaron Hill | Case Manager/Care Coordinator | 2126 N. 1st St Suite F, Jacksonville, AR 72076 | 2012-05-11 |
| 1396023156 | Syreeta Tucker | Case Manager/Care Coordinator | 1109 Burman, Jacksonville, AR 72076 | 2011-07-28 |
| Find all providers in zip 72076 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508114406 | Loy P Scruggs Jr. | Specialist/Technologist, Other | 3313 County Road 4216, Jacksonville, TX 75766-7334 | 2012-08-27 |
| 1821614389 | Megan L Minser | Specialist/Technologist, Other | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-06-22 |
| 1821623000 | Kevin Reid Scyoc | Specialist/Technologist, Other | 461 Western Blvd Ste 122, Jacksonville, NC 28546-7637 | 2020-03-07 |
| 1306483425 | Evonna Almtanious | Specialist/Technologist, Other | 6410 Beach Blvd, Jacksonville, FL 32216-2813 | 2019-12-09 |
| 1154801496 | Kelsea Mitchell | Specialist/Technologist, Other | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2018-08-16 |
| 1972014546 | Emily Ann Krieg | Specialist/Technologist, Other | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2017-10-23 |
| 1770016115 | Premier Neuro Therapy LLC | Specialist/Technologist, Other | 14255 Beach Blvd, Jacksonville, FL 32250-1576 | 2017-04-04 |
| 1295195758 | Rebecca Riemer | Specialist/Technologist, Other | 2227 West Main Street, Suite 3, Jacksonville, AR 72076 | 2016-02-26 |
| 1881090983 | Jessie Battles | Specialist/Technologist, Other | 2227 W Main St Ste 3, Jacksonville, AR 72076-4251 | 2014-11-17 |
| 1972898146 | Barbara Casey Medlin | Specialist/Technologist, Other | 714 New Bridge St, Jacksonville, NC 28540-5435 | 2011-06-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
Please comment or provide details below to improve the information on MISTY ANGELIQUE ROETZEL.
| 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.