JUSTIN GERALD TATTERSALL


Address: 625 E Broadway Ave, Jackson, WY 83001-8642
Phone: 3077333636

JUSTIN GERALD TATTERSALL (NPI# 1518479104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518479104
Entity Type Individual
Full Name JUSTIN GERALD TATTERSALL
Practice Address 625 E Broadway Ave
Jackson
WY 83001-8642
Mailing Address Po Box 9871
Jackson
WY 83002-9871
Practice Telephone 3077333636
Mailing Telephone 3074130437
Enumeration Date 2017-11-03
Last Update Date 2017-11-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WR0006X Registered Nurse
Specialization: Registered Nurse First Assistant
30955 WY Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NONE 3074130437 01

Office Location

Street Address 625 E BROADWAY AVE
City JACKSON
State WY
Zip Code 83001-8642

Providers in the same location

NPI Name Taxonomy Address Enumeration
1679534432 Lars T Conway Pathology 625 E Broadway Ave, Jackson, WY 83001-8642 2006-03-31
1154969251 Michelle Robertson Dietitian, Registered 625 E Broadway Ave, Jackson, WY 83001-8642 2019-12-19
1942848072 Anna Sigrid Eide Dietitian, Registered 625 E Broadway Ave, Jackson, WY 83001-8642 2019-12-19
1104464734 Lisa Lauritzen Smith Dietitian, Registered 625 E Broadway Ave, Jackson, WY 83001-8642 2019-12-13
1598325193 Katrina Rush Occupational Therapist 625 E Broadway Ave, Jackson, WY 83001-8642 2019-06-17
1669949590 Elizabeth Smith Dannewald Nurse Practitioner 625 E Broadway Ave, Jackson, WY 83001 2018-10-29
1528533973 Hanna Kirsten Occupational Therapy Assistant 625 E Broadway Ave, Jackson, WY 83001-8642 2018-10-11
1891270500 Jamie Loomis Physical Therapy Assistant 625 E Broadway Ave, Jackson, WY 83001-8642 2018-09-27
1942784806 Jared Travis Martin Physical Therapy Assistant 625 E Broadway Ave, Jackson, WY 83001-8642 2018-09-17
1891274320 Wendy Carbone Physical Therapist 625 E Broadway Ave, Jackson, WY 83001-8642 2018-08-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861006108 Anne Kathleen Milburn Physical Therapist 3620 S Park Drive, Jackson, WY 83001 2020-09-03
1568009637 Katherine Pringle Ford Case Manager/Care Coordinator 2065 E. Limber Pine Road, Jackson, WY 83001 2019-12-07
1043878408 Cossette Burnham Physical Therapist Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 2019-05-31
1982169371 Cynthia Buck Huyffer Social Worker 755a Cache Creek Drive, Jackson, WY 83001 2019-02-10
1093281594 Lara Cilo Speech-Language Pathologist 1300 W. Valley Springs Road, Jackson, WY 83001 2018-10-23
1740776202 Teton Oral and Maxillofacial Surgery Dentist 1160 Alpine Ln Ste 1d, Jackson, WY 83001 2018-07-09
1437642055 Anna Yanchek Physical Therapist 1090 Us- 89, Jackson Hole, WY 83001 2018-06-08
1891200762 Tyler Ross Wright Chiropractor 1325 Us-89, Suite 108, Jackson, WY 83001 2017-12-13
1073027280 Root To Rise Counseling and Consulting, Pllc Social Worker 2033 Dandelion Court, Jackson, WY 83001 2017-11-27
1962923912 Piper Worthington Social Worker 1910 High School Rd, Jackson, WY 83001 2017-06-29
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Taxonomy Information

Taxonomy Code 163WR0006X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Registered Nurse First Assistant

Taxonomy Definition

A perioperative registered nurse who works in collaboration with the surgeon and other health care team members to achieve optimal outcomes. The RNFA has acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice. Intraoperatively, the RNFA assists the surgeon.
Notes: Source: AORN Official Statement on RNFAs ratified by the AORN House of Delegates in 2004. [7/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003349465 Teton Surgical Assist Services LLC Registered Nurse 1200 Melody Creek Ln, Jackson, WY 83001-8982 2017-04-04
1144732736 4js LLC Registered Nurse 625 E Broadway Ave, Jackson, WY 83001-8642 2017-11-03
1083149181 John Causey Registered Nurse 1325 E Fortification St, Jackson, MS 39202-2442 2017-04-26
1053768879 Jodie Kilby Registered Nurse 2500 N State St, Jackson, MS 39216-4500 2016-05-22
1073969952 Wanda G Bounds Registered Nurse 2500 N State St, Jackson, MS 39216-4500 2016-05-10
1164834362 Maricyl Terry Registered Nurse 971 Lakeland Dr Ste 950, Jackson, MS 39216-4608 2014-05-22
1992120604 Summers Helping Hands, LLC Registered Nurse 2105 Lilac Ln, Jackson, WY 83001-8560 2014-03-04
1730480286 Melissa Jones Registered Nurse 1421 N State St, Suite 403, Jackson, MS 39202-1658 2010-11-14
1336471119 Melinda J. Engel Registered Nurse 971 Lakeland Dr, Ste 750 Mississippi Oncology Associates, Jackson, MS 39216 2010-02-04
1689903858 Laura C Evans Registered Nurse 971 Lakeland Dr, Suite 1250, Jackson, MS 39216-4643 2009-12-16
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Competitor

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City JACKSON
Zip Code 83001

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Dataset Information

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.

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