MR. MICHAEL L HAVENAR (NPI# 1770723082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770723082 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL L HAVENAR |
| Credential | ACNP |
| Practice Address |
4901 Forest Park Ave Ste 420 Ste 420 Saint Louis MO 63108-1453 |
| Mailing Address |
660 S Euclid Ave C B 8109 Saint Louis MO 63110-1010 |
| Practice Telephone | 3143625298 |
| Practice Fax Number | 3143625743 |
| Mailing Telephone | 3143625298 |
| Mailing Fax Number | 3143625743 |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2018-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
2003001555 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ENROLLED | 05 |
| Street Address |
4901 FOREST PARK AVE STE 420 STE 420 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-1453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225088891 | Obeid Noor Ilahi | Surgery | 4901 Forest Park Ave Ste 420, Ste 420, Saint Louis, MO 63108-1453 | 2006-05-12 |
| 1073740890 | Chun-cheng Chen | Surgery | 4901 Forest Park Ave Ste 420, Ste 420, Saint Louis, MO 63108-1453 | 2009-06-18 |
| 1194975441 | Isaiah Richard Turnbull | Anesthesiology | 4901 Forest Park Ave Ste 420, Ste 420, Saint Louis, MO 63108-1453 | 2008-09-23 |
| 1447419320 | Jason A Snyder | Anesthesiology | 4901 Forest Park Ave Ste 420, Ste 420, Saint Louis, MO 63108-1453 | 2008-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841897394 | Lara Kang | Nurse Practitioner | 7354 S Yorkshire Dr, Saint Louis, MO 63123-2111 | 2020-10-07 |
| 1265064703 | Kelsey Elizabeth Ortmann | Nurse Practitioner | 4962 Tyrolean Ave, Saint Louis, MO 63109-3760 | 2020-02-11 |
| 1427606250 | Erin Kate Adlon | Nurse Practitioner | 1 Barnes Jewish Hospital Plz # 10400, Saint Louis, MO 63110-1003 | 2019-08-26 |
| 1164993622 | Alexandra Nicole Shero | Nurse Practitioner | 660 South Euclid Avenue #8054, Saint Louis, MO 63110-1010 | 2018-12-10 |
| 1932647302 | Lorena Zerwig | Nurse Practitioner | 3219 Portis Ave, Saint Louis, MO 63116-2025 | 2017-02-06 |
| 1780011023 | Elvisa Kurtovic | Nurse Practitioner | 4921 Parkview Pl Fl 6, 6 Fl, Saint Louis, MO 63110-1032 | 2013-10-01 |
| 1275863441 | Katheryne Tifuh Amba | Nurse Practitioner | 999 Executive Parkway Dr Ste 210, Saint Louis, MO 63141-6336 | 2010-01-11 |
| 1346579281 | Advanced Icu Care | Nurse Practitioner | 999 Executive Parkway Dr, Ste 210, Saint Louis, MO 63141-6336 | 2009-12-23 |
| 1235135237 | Loretta Jane Colvin | Nurse Practitioner | 2531 S Big Bend Blvd, Saint Louis, MO 63143-2112 | 2005-06-23 |
| 1295335966 | Tracy Novak | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2020-10-30 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
Please comment or provide details below to improve the information on MR. MICHAEL L HAVENAR.
| 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.