MISS MICAELA L GOEBEL (NPI# 1336617059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336617059 |
| Entity Type | Individual |
| Full Name | MISS MICAELA L GOEBEL |
| Credential | PA-C |
| Practice Address |
120 Tanner Pl Bldg H Clinton TN 37716-6684 |
| Mailing Address |
Po Box 787 Jacksboro TN 37757-0787 |
| Practice Telephone | 8652644012 |
| Practice Fax Number | 4235674722 |
| Mailing Telephone | 4236581406 |
| Mailing Fax Number | 8652811625 |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2019-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3700 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1030 Oak Ridge Tpke, Oak Ridge, TN 378306804 | 8656850285 | 4235674722 |
| 2702 Jacksboro Pike, Jacksboro, TN 377574850 | 4232019937 | 4235674722 |
| Street Address |
120 TANNER PL BLDG H |
| City | CLINTON |
| State | TN |
| Zip Code | 37716-6684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730650870 | Kellye Watkins Wilson | Dental Hygienist | 420 S. Charles Seivers Blvd, Clinton, TN 37716 | 2018-12-16 |
| 1326428087 | Sandra Ella Humphrey Mincey | Registered Nurse | Mcneeley Family Physicians, 110 Executive Park Drive, Clinton, TN 37716 | 2015-06-08 |
| 1598157224 | Susan Price Teffeteller | Nurse Practitioner | 159 Frank L Diggs Road, Clinton, TN 37716 | 2015-03-04 |
| 1710268065 | Jimmy Neil Mcbride | Pharmacist | 1130 North Charles G. Seivers Boulevard, Clinton Drug Store, Clinton, TN 37716 | 2011-08-31 |
| 1265684658 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 507 South Charles Sevier Boulevard, Clinton, TN 37716 | 2008-10-16 |
| 1912186016 | Comprehensive Industrial Services Inc | Physical Therapist | 1107 Charles Seivers Blvd, Suite 2, Clinton, TN 37716 | 2007-10-25 |
| 1205039120 | Pamela H. Gross, Ph.d, P.C. | Psychologist | 1729 Dutch Valley Road, Clinton, TN 37716 | 2007-06-07 |
| 1396872057 | Health Care Inc | Pharmacy | 1130 N Charles Seivers Blvd, Clinton, TN 37716 | 2007-02-28 |
| 1346389889 | Kellie Gaetz | Physical Therapist | 1115 Charles Seivers Blvd, Suite 22, Clinton, TN 37716 | 2007-02-05 |
| 1396883955 | Phoenix Counseling Services, Inc. | Counselor | 729 Charles Seivers, Clinton, TN 37716 | 2007-02-02 |
| Find all providers in zip 37716 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407944721 | Brent Ashley Westbrook | Physician Assistant | 48 Stillwater Ln, Clinton, NC 28328-6119 | 2006-10-11 |
| 1699881219 | Heather Lynn Beck | Physician Assistant | 10401 Hospital Dr Ste 101, Clinton, MD 20735-3150 | 2006-08-23 |
| 1760042782 | Alexandra Jo Burrini | Physician Assistant | 59 Old Highway 22, Clinton, NJ 08809-1342 | 2019-06-20 |
| 1801349279 | Sara Cobb | Physician Assistant | 59 Old Highway 22, Clinton, NJ 08809-1342 | 2016-08-02 |
| 1861844979 | Will Godfrey | Physician Assistant | 22725 Highway 76 E, Clinton, SC 29325-7527 | 2016-07-13 |
| 1538526959 | Suzzette Van-lare | Physician Assistant | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2016-01-16 |
| 1811371685 | Dermone | Physician Assistant | 603 Beaman St, Clinton, NC 28328-2650 | 2015-07-12 |
| 1477940898 | Melissa Weeter | Physician Assistant | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2015-04-23 |
| 1982097085 | Mirella Cortez | Physician Assistant | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2015-03-13 |
| 1013308972 | Eline Leonore Mul | Physician Assistant | 7801 Old Branch Ave, Suite 202, Clinton, MD 20735-1608 | 2015-02-13 |
| Find all providers in CLINTON | ||||
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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.