SARA LYNN BRAKEBUSH (NPI# 1558518381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558518381 |
| Entity Type | Individual |
| Full Name | SARA LYNN BRAKEBUSH |
| Credential | NP |
| Practice Address |
1750 Thompson Rd Coos Bay OR 97420-2100 |
| Practice Telephone | 5412664402 |
| Mailing Telephone | 5412664402 |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2008-08-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
200850111NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1750 THOMPSON RD |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004365 | Andrew Rowe Maslona | Internal Medicine | 1750 Thompson Rd, Coos Bay, OR 97420 | 2005-06-21 |
| 1679181069 | Jodi Sue Tavernier | Case Manager/Care Coordinator | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-07-21 |
| 1477161206 | Sarah Brady | Case Manager/Care Coordinator | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-07-17 |
| 1508490400 | Trisha Gederos | Social Worker | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-02-28 |
| 1568096188 | Heath Gerig | Nurse Practitioner | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2020-02-24 |
| 1710527726 | Sara Ferrell | Social Worker | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2020-01-08 |
| 1295245108 | Davina Lynn Bledsoe | Family Medicine | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2017-10-05 |
| 1518312362 | Sarah Marie Strawn | Acupuncturist | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2016-04-29 |
| 1982088464 | Alex Michael Spencer | Surgery | 1750 Thompson Rd, Coos Bay, OR 97420-2195 | 2015-07-15 |
| 1720483266 | Jason Hayes | Nurse Practitioner | 1750 Thompson Rd, Coos Bay, OR 97420-2100 | 2014-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197705 | Kelsey-jo Audrey Moss | Nurse Practitioner | 704b Ne 62nd Ave, Portland, OR 97213-4351 | 2019-10-30 |
| 1295273399 | Shaudine Woody | Nurse Practitioner | 11790 Sw Barnes Rd Ste 140, Portland, OR 97225-5938 | 2017-02-08 |
| 1457707390 | Sarah Halstead | Nurse Practitioner | 2421 Washburn Way, Klamath Falls, OR 97603-4525 | 2016-05-10 |
| 1164829578 | Debdeep Nath | Nurse Practitioner | 12225 Sw 2nd St Ste 150, Beaverton, OR 97005 | 2014-12-01 |
| 1003239120 | Iva Juric | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239-3011 | 2014-01-24 |
| 1912339896 | Gabrielle Marie Petersen | Nurse Practitioner | 1713 Penn Ln, Oregon City, OR 97045-1528 | 2013-08-02 |
| 1811249592 | Pollee Hruby Brookings | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw7, Portland, OR 97239-3098 | 2012-10-05 |
| 1033470646 | Chelsea Doherty | Nurse Practitioner | 14480 Sw 90th Ave, Portland, OR 97224 | 2012-05-31 |
| 1972814440 | Alicia Marie Mcintire | Nurse Practitioner | 995 Willagillespie Rd # 100, Eugene, OR 97401-2186 | 2010-06-29 |
| 1255662953 | Elizabeth T Millan | Nurse Practitioner | 2150 Ne Daggett Ln, Bend, OR 97701-6560 | 2010-01-19 |
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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.