LAURA JEAN BURNSIDE-MCELLIGOTT (NPI# 1477718419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477718419 |
| Entity Type | Individual |
| Full Name | LAURA JEAN BURNSIDE-MCELLIGOTT |
| Other Name | LAURA JEAN MCELLIGOTT |
| Practice Address |
1890 Waite St Ste 1 North Bend OR 97459-1229 |
| Practice Telephone | 5417566232 |
| Practice Fax Number | 5417566234 |
| Mailing Telephone | 5417566232 |
| Mailing Fax Number | 5417566234 |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2012-06-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 081046951RN | OR | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
200850064NP FNP- | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500617181 | 05 | |
| MEDICARE PTAN | R163722 | 01 | |
| OR | 213342 | 05 |
| Street Address |
1890 WAITE ST STE 1 |
| City | NORTH BEND |
| State | OR |
| Zip Code | 97459-1229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316921646 | Innovative Physical Therapy, Inc | Physical Therapist | 1890 Waite St, Suite 5, North Bend, OR 97459-1229 | 2005-11-30 |
| 1083246730 | Lori Shott | Registered Nurse | 1890 Waite St, North Bend, OR 97459-1229 | 2020-02-11 |
| 1689141236 | Toyin A Akanni | Nurse Practitioner | 1890 Waite St, North Bend, OR 97459-1229 | 2018-10-31 |
| 1043719990 | Shu-wen Cheng | Nurse Practitioner | 1890 Waite St, North Bend, OR 97459-1229 | 2018-02-06 |
| 1639555436 | Stephanie Hodges | Nurse Practitioner | 1890 Waite St, North Bend, OR 97459-1229 | 2015-08-04 |
| 1629366216 | Cathleen Marie Delibero | Counselor | 1890 Waite St, North Bend, OR 97459-1229 | 2011-07-15 |
| 1891978763 | Judith Myrick Randall | Nurse Practitioner | 1890 Waite St, Ste 1, North Bend, OR 97459-1229 | 2007-12-13 |
| 1518164201 | Astrid Diepenbroek | Dental Hygienist | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 | 2007-06-27 |
| 1114137494 | Gladys Shade | Social Worker | 1890 Waite St, Suite 1, North Bend, OR 97459-1229 | 2007-05-23 |
| 1780627166 | Maria G. Maldonado | Nurse Practitioner | 1890 Waite St, Suite1, North Bend, OR 97459-1229 | 2006-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| 1629573977 | Heather M Coates | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459 | 2018-03-28 |
| 1205257219 | Melissa Sperry | Health Educator | 510 Lockhart Street, North Bend, OR 97459 | 2013-12-17 |
| 1265862627 | Elizabeth Sylvester | Counselor | 1592 Monroe Street, North Bend, OR 97459 | 2013-11-22 |
| 1124370291 | Brian Noble Thompson | Pharmacist | 3411 Broadway St., North Bend, OR 97459 | 2012-10-12 |
| 1295081230 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3411 Broadway St, North Bend, OR 97459 | 2012-07-27 |
| 1366728370 | Melissa Jean Kovach | Occupational Therapy Assistant | 3959 Sheridan Ave., North Bend, OR 97459 | 2011-10-24 |
| 1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
| 1902080013 | Anthony Eugene Baldacci | Registered Nurse | 1836 Meade Street, North Bend, OR 97459 | 2007-12-26 |
| 1952595340 | Inland Point Senior Estates Jv LLC | Clinic/Center | 2265 Inland Drive, North Bend, OR 97459 | 2007-08-29 |
| Find all providers in zip 97459 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043832041 | Lorie Ann Kelley Norton | Nurse Practitioner | 930 Cottonwood St, North Bend, NE 68649-3511 | 2020-05-12 |
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| 1205307949 | Yanidit Diaz Martinez | Nurse Practitioner | 209 Main Ave S Ste 115, North Bend, WA 98045-8139 | 2018-12-06 |
| 1558490649 | Linda S Brodbeck | Nurse Practitioner | 7995 Count Fleet Court, North Bend, OH 45052 | 2007-03-05 |
| 1548213614 | Barbara L Eisenberg | Nurse Practitioner | 406 Main Ave S, North Bend, WA 98045 | 2006-05-18 |
| 1609860212 | Hedian C Swanson | Nurse Practitioner | 2191 Marion St, North Bend, OR 97459-2314 | 2005-09-09 |
| 1235764143 | Jacklyn Hardin | Nurse Practitioner | 1950 Waite St, North Bend, OR 97459-1228 | 2020-03-11 |
| 1639555436 | Stephanie Hodges | Nurse Practitioner | 1890 Waite St, North Bend, OR 97459-1229 | 2015-08-04 |
| 1255627253 | Debra Sue Guzman | Nurse Practitioner | 1890 Waite St Ste 1, North Bend, OR 97459-1229 | 2011-06-28 |
| 1891978763 | Judith Myrick Randall | Nurse Practitioner | 1890 Waite St, Ste 1, North Bend, OR 97459-1229 | 2007-12-13 |
| Find all providers in NORTH BEND | ||||
| City | NORTH BEND |
| Zip Code | 97459 |
Please comment or provide details below to improve the information on LAURA JEAN BURNSIDE-MCELLIGOTT.
| 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.