JACKIE B MICHAEL-HAVENS


Address: 500 5th St, Brookings, OR 97415-9702
Phone: 5414122000

JACKIE B MICHAEL-HAVENS (NPI# 1548701600) 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) 1548701600
Entity Type Individual
Full Name JACKIE B MICHAEL-HAVENS
Credential NP
Practice Address 500 5th St
Brookings
OR 97415-9702
Practice Telephone 5414122000
Practice Fax Number 5414122081
Mailing Telephone 5414122000
Mailing Fax Number 5414122081
Enumeration Date 2017-03-09
Last Update Date 2020-09-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
202000081-NP-PP OR Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR CURRY MEDICAL CENTER NPI 1083656367 01
OR CURRY GENERAL HOSPITAL NPI 1487696985 01
OR 500776554 05

Office Location

Street Address 500 5TH ST
City BROOKINGS
State OR
Zip Code 97415-9702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245226935 Stephen W Shea Orthopaedic Surgery 500 5th St, Brookings, OR 97415-9702 2005-09-27
1174167555 Brian Duncan Sinnott Physician Assistant 500 5th St, Brookings, OR 97415-9702 2019-10-29
1740821453 Kellie Marie Creaser Nurse Practitioner 500 5th St, Brookings, OR 97415-9702 2019-10-03
1700440856 Oregon Em-i Medical Services PC Physician Assistant 500 5th St, Brookings, OR 97415-9702 2019-04-24
1073070678 Lacy Ann Woods Occupational Therapist 500 5th St, Brookings, OR 97415-9702 2019-03-01
1689195505 Steven T. Brantingham Podiatrist 500 5th St, Brookings, OR 97415-9702 2017-06-30
1083088199 Tiffanie Newman Occupational Therapist 500 5th St, Brookings, OR 97415-9702 2015-12-01
1538537469 Oregon Em-i Medical Services PC Physician Assistant 500 5th St, Brookings, OR 97415-9702 2015-09-09
1457730632 Harris Beach Emergency Physicians LLC Emergency Medicine 500 5th St, Brookings, OR 97415-9702 2015-05-21
1124443676 Shana S Stark Nurse Practitioner 500 5th St, Brookings, OR 97415-9702 2014-02-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013549575 Christopher Scott Mayo Jr. Denturist 937 Chetco Ave Ste. B, Brookings, OR 97415 2020-02-12
1912564329 Lori A Burkart Speech-Language Pathologist Curry Medical Ctr, 500 5th Street, Brookings, OR 97415 2019-05-21
1881144178 Costa Clinical Psychology, LLC Social Worker 625 Spruce St., # 7666, Brookings, OR 97415 2016-10-11
1194173898 Columbiacare Services Community Based Residential Treatment Facility, Mental Illness 410 Maple St, Brookings, OR 97415 2016-06-03
1336595784 Monica Shaw Case Manager/Care Coordinator 412 Alder, Brookings, OR 97415 2016-05-04
1639531437 Ian Leonard Behavioral Analyst 450 Sb Chetco River Road, Brookings, OR 97415 2016-03-22
1518201151 Columbacare Services Community Based Residential Treatment Facility, Mental Illness 210 Cove Lane, Brookings, OR 97415 2012-11-20
1699033365 Sunlight Family Center, LLC Clinic/Center 604 Spruce Street, Brookings, OR 97415 2012-05-01
1649544784 Oregon Coast Wellness Inc. Clinic/Center 648 Chetco Ave., Brookings, OR 97415 2012-03-07
1790072544 Elizabeth A. Nation Registered Nurse 96343 Alder Ridge Road, Brookings, OR 97415 2011-06-30
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619364742 Tanya Llanque Nurse Practitioner 500 Main Ave Unit 883, Brookings, SD 57006-7647 2015-04-15
1821272790 Debra Ann Burlage Nurse Practitioner Wellness Center 154, 2818, Brookings, SD 57007-0001 2007-12-27
1861538274 Tracey S Kather Nurse Practitioner 97825 Shopping Center Ave., Brookings, OR 97415 2007-01-30
1285710616 Brenda Fern Andersen Nurse Practitioner Sdsu Student Health Clinic, N. Campus Drive, Brookings, SD 57007-0001 2006-10-27
1194807511 Lindsay Marie Rheault Nurse Practitioner Wellness Ctr, Box 2818, Brookings, SD 57007-0001 2006-10-19
1508802802 Jennifer M. Boyle Nurse Practitioner 585 5th St, Brookings, OR 97415-9702 2006-06-22
1235170564 Carol Oliver Nurse Practitioner 413 Mill Beach Rd, Brookings, OR 97415-9690 2006-06-09
1700873528 Melissa Louise Wilson Nurse Practitioner 524 Spruce Street Unit 3, Brookings, OR 97415 2005-10-06
1568461804 Janine Dawn Bassett Nurse Practitioner 400 22nd Ave, Brookings, SD 57006-2450 2005-07-19
1295731644 Carla Dieter Nurse Practitioner Sdsu Health & Counseling Clinc, Brookings, SD 57007-0001 2005-06-21
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Competitor

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City BROOKINGS
Zip Code 97415

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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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