MS. BEVERLY A JEANNETTE (NPI# 1770717068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770717068 |
| Entity Type | Individual |
| Full Name | MS. BEVERLY A JEANNETTE |
| Credential | HIS |
| Practice Address |
117 N Hwy 141 Suite 104 Crivitz WI 54114-1686 |
| Mailing Address |
1620 Willow Creek Rd Lot 3 Escanaba MI 49829-4328 |
| Practice Telephone | 7158543432 |
| Practice Fax Number | 9067899539 |
| Mailing Telephone | 9067899539 |
| Mailing Fax Number | 9067899539 |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-05-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | WI1066 | WI | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42830900 | 05 |
| Street Address |
117 N HWY 141 SUITE 104 |
| City | CRIVITZ |
| State | WI |
| Zip Code | 54114-1686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548437155 | Crivitz Medical Center | Family Medicine | 213 S Hwy 141, Crivitz, WI 54114 | 2008-05-13 |
| 1306200472 | Kellen Blanck-grott | Chiropractor | 709 Dyer St, Crivitz, WI 54114 | 2016-04-05 |
| 1306048822 | Glen R Ledvina | Chiropractor | 107 N Highway 141, Crivitz, WI 54114-0008 | 2007-06-05 |
| 1306063185 | Newcare Inc | Physical Therapist | 903 Main Avenue, Crivitz, WI 54114-0460 | 2007-04-20 |
| 1700984374 | Kevin J Pepin | Dentist | 302 Hall Avenue, Crivitz, WI 54114-1442 | 2006-09-20 |
| 1780637595 | The Crivitz Rescue Squad, Inc | Ambulance | 1020 Henriette Ave, Crivitz, WI 54114-1536 | 2006-05-19 |
| 1720410038 | Virginia L Deschane | Registered Nurse | 602 Lulu Ave, Crivitz, WI 54114-1584 | 2013-08-08 |
| 1659878122 | Erin Marie Rill | Registered Nurse | 602 Lulu Ave, Crivitz, WI 54114-1584 | 2018-04-10 |
| 1467574236 | New Care, Inc. | Skilled Nursing Facility | 903 Main Ave, Crivitz, WI 54114-1619 | 2007-04-04 |
| 1861793622 | Chassie Le Olson | Physical Therapy Assistant | 903 Main Ave, Crivitz, WI 54114-1619 | 2010-11-10 |
| Find all providers in zip 54114 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043835440 | Michael Dale Shoultz | Specialist | 2622 Hoard St, Madison, WI 53704-4827 | 2020-06-11 |
| 1134752934 | Denise Douglass | Specialist | 31 Northstar Ln, Saint Croix Falls, WI 54024-9005 | 2020-02-20 |
| 1164065025 | Susan Jane Janz | Specialist | 1014 W Thomas St, Wausau, WI 54401-5986 | 2019-10-23 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1982161048 | Natalia Roman | Specialist | 725 W Lapham Blvd Apt 17, Milwaukee, WI 53204-3447 | 2019-02-25 |
| 1598231524 | Shanel Marie Jordan | Specialist | 4827 N 76th St, Milwaukee, WI 53218-3826 | 2018-10-17 |
| 1386191799 | Dallas Roger Loukes | Specialist | 323 W Monroe St, Wyocena, WI 53969 | 2016-09-01 |
| 1285084368 | Madison Swim Academy | Specialist | 605 Chase Blvd, Sun Prairie, WI 53590-2382 | 2016-06-20 |
| 1851745905 | Kristyn Zahorik | Specialist | 7515 W Coldspring Rd, Greenfield, WI 53220-2814 | 2016-04-14 |
| 1104297274 | Andrea Renee Keapproth | Specialist | 433 W Washington Ave, Madison, WI 53703-3482 | 2015-10-14 |
| Find all providers with the same taxonomy | ||||
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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.