FOREST WAYNE SHIRA (NPI# 1689001000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689001000 |
Entity Type | Individual |
Full Name | FOREST WAYNE SHIRA |
Credential | FNP-C |
Practice Address |
1863 Ne Freemont Ave Roseburg OR 97470-3535 |
Practice Telephone | 5417332230 |
Mailing Telephone | 5417332230 |
Enumeration Date | 2013-09-30 |
Last Update Date | 2014-04-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201392914NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1863 NE FREEMONT AVE |
City | ROSEBURG |
State | OR |
Zip Code | 97470-3535 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
Find all providers in zip 97470 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275194359 | Jennifer Ann Frost | Nurse Practitioner | 3369 Ne Stephens St # A, Roseburg, OR 97470-1200 | 2019-06-27 |
1730631375 | Alicia Denning Morrison | Nurse Practitioner | 2510 Nw Edenbower Blvd., Suite 152, Roseburg, OR 97471-8899 | 2016-10-31 |
1114337698 | Morgan Michelle Petersen | Nurse Practitioner | 427 W Carroll Ct, Roseburg, OR 97471-2368 | 2014-05-05 |
1700180098 | Rebekah Anna Syverson | Nurse Practitioner | 1318 Cattle Dr, Roseburg, OR 97470 | 2010-12-31 |
1609070531 | Wendy Zyzniewski | Nurse Practitioner | 201 Nw Medical Loop Ste 170, Roseburg, OR 97471-8835 | 2007-06-13 |
1588750228 | Eileen M Tabert | Nurse Practitioner | 544 W Umpqua St, Roseburg, OR 97470 | 2006-10-04 |
1093741449 | Mary E. Orians | Nurse Practitioner | 272 Nw Medical Loop Ste B, Roseburg, OR 97471-5545 | 2006-06-25 |
1255327151 | Janus Maybee | Nurse Practitioner | 1404 Se Mill St, Roseburg, OR 97470-4008 | 2005-09-26 |
1598301582 | James William Southam | Nurse Practitioner | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2019-11-25 |
1790243988 | Michelle Noelle Phelps | Nurse Practitioner | 1700 Nw Garden Valley Blvd Ste 201, Roseburg, OR 97471-1636 | 2019-03-06 |
Find all providers in ROSEBURG |
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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.