JESSE MISTHAVEN (NPI# 1720685175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720685175 |
Entity Type | Individual |
Full Name | JESSE MISTHAVEN |
Credential | RN |
Practice Address |
6333 E Skelly Dr Tulsa OK 74135-6106 |
Practice Telephone | 9186644224 |
Mailing Telephone | 9186644224 |
Enumeration Date | 2020-10-07 |
Last Update Date | 2020-10-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
99598 | OK | Nursing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | RN | 05 |
Street Address |
6333 E SKELLY DR |
City | TULSA |
State | OK |
Zip Code | 74135-6106 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053317883 | 12 & 12, Inc. | Substance Abuse Rehabilitation Facility | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2005-06-27 |
1699372482 | Christine Reynold | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-10-05 |
1679185920 | Kacey Ann Cottrell | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-08-18 |
1861003931 | Matthew Schane | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-08-12 |
1841817368 | Bernadette Bouciquot | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-30 |
1568088011 | Brenda Kay Kuntzelman | Licensed Practical Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-21 |
1023634698 | Kelli Ann Ordorica | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-19 |
1215552120 | Amanda Lindsey Spicer | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-16 |
1619592672 | Tieraney Candice Rodriguez | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-06-15 |
1043846447 | Meghan R Comer | Case Manager/Care Coordinator | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-03-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437761590 | Dr. Whitney M. Ellsworth, Dpt, Pllc | Physical Therapist | 4185 S Harvard Ave, Suite E-1, Tulsa, OK 74135 | 2020-08-20 |
1942839089 | Kimberly Renee Gillens | Student in an Organized Health Care Education/Training Program | 4502 E 41st Street Obgyn Department, Tulsa, OK 74135 | 2020-04-01 |
1528525524 | Everest Pain Management | Clinic/Center | 4134 S Harvard Ave Suite B1, Tulsa, OK 74135 | 2019-02-26 |
1326524216 | Shelley Deeann Anderson | Technician | 7359 S 68th, Tulsa, OK 74135 | 2018-07-14 |
1811489065 | Taylor Diane Spears | Behavioral Analyst | 4835 S Fulton Ave Suite 104, Tulsa, OK 74135 | 2018-06-04 |
1225547821 | Heather Nicole Freed | Counselor | 4363 S Harvard Ave, Tulsa, OK 74135 | 2017-09-26 |
1306363924 | Danielle Walker | Case Manager/Care Coordinator | 3244 S Lakewood Ave Apt 4e, Tulsa, OK 74135 | 2017-08-24 |
1346766078 | Angels Place | Day Training, Developmentally Disabled Services | 3919 S. Oswego Avenue, Tulsa, OK 74135 | 2017-08-15 |
1659800019 | Welena-phay Kamamma Boren | Counselor | 4636 S Harvard Avenue, Tulsa, OK 74135 | 2017-06-08 |
1346774197 | Brandie Herren | Registered Nurse | 6333 E Skelly Drive, Tulsa, OK 74135 | 2017-04-19 |
Find all providers in zip 74135 |
Taxonomy Code | 163WP0807X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Psych/Mental Health, Child & Adolescent |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699372482 | Christine Reynold | Registered Nurse | 6333 E Skelly Dr, Tulsa, OK 74135-6106 | 2020-10-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629553771 | Cierra Chapa | Registered Nurse | 600 S. Choctaw, El Reno, OK 73036 | 2018-09-25 |
1053817775 | Emilia Sue Lopez | Registered Nurse | 2008 East 2110 Road, Hugo, OK 74743 | 2018-04-02 |
1265514616 | Theresa Marie Hanus | Registered Nurse | 250 Henry St, Delaware, OK 43015 | 2006-10-19 |
1417503038 | Amy Melissa Fleming | Registered Nurse | 1707 Professional Cir, Yukon, OK 73099-6470 | 2019-08-11 |
1427613488 | Robin Marie Lacy | Registered Nurse | 1707 Professional Cir, Yukon, OK 73099-6470 | 2019-05-06 |
1558725713 | Ashley Lee | Registered Nurse | 3400 Deskin Dr, Norman, OK 73069-8295 | 2016-04-13 |
1699132126 | Kelly Nix | Registered Nurse | 400 N Broadway St, Moore, OK 73160-4812 | 2016-01-28 |
1255704821 | Lisa Lumry | Registered Nurse | 3400 Deskin Dr, Norman, OK 73069-8295 | 2015-11-04 |
1669883781 | Connie Jo Johnson | Registered Nurse | 2601 Spencer Rd, Spencer, OK 73084-3649 | 2014-05-12 |
1629320890 | Tara Herren | Registered Nurse | 7908 Nw 23rd St, Bethany, OK 73008-4950 | 2012-10-11 |
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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.