MYRA BROOKE FLEMISTER (NPI# 1982128096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982128096 |
| Entity Type | Individual |
| Full Name | MYRA BROOKE FLEMISTER |
| Other Name | MYRA BROOKE EVANS |
| Credential | APRN |
| Practice Address |
233 N Main St Portland AR 71663-9230 |
| Mailing Address |
Po Box 509 Dermott AR 71638-0509 |
| Practice Telephone | 8707372221 |
| Mailing Telephone | 8705385414 |
| Mailing Fax Number | 8705385412 |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2019-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
A005228 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
233 N MAIN ST |
| City | PORTLAND |
| State | AR |
| Zip Code | 71663-9230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376841247 | Byron K Montgomery | Nurse Practitioner | 233 N Main St, Portland, AR 71663-9230 | 2011-03-02 |
| 1316106388 | Mainline Health Systems Inc | Clinic/Center | 233 N Main St, Portland, AR 71663 | 2008-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396074886 | Amy Floyd | Social Worker | 233 North Main, Portland, AR 71663 | 2009-12-14 |
| 1891942975 | Jeannie Rebecca Tucker | Counselor | 233 N Main, Portland, AR 71663 | 2008-08-20 |
| 1578770582 | Portland Drug Inc. | Pharmacy | 105 Hwy 165 South, Portland, AR 71663 | 2007-05-17 |
| 1942611504 | Portland Drug LLC | Pharmacy | 105 Hwy 65 South, Portland, AR 71663-0000 | 2014-05-16 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013712 | Gabriel Henriques | Massage Therapist | 805 Se Peacock Ln, Portland, OR 97214-3278 | 2020-11-07 |
| 1669073490 | Krista Marie Obenlock | Acupuncturist | 2408 N Baldwin St, Portland, OR 97217-6404 | 2020-11-06 |
| 1265033088 | Palms Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Forest Ave Apt 13d, Portland, ME 04103-1846 | 2020-11-06 |
| 1104427160 | Kristine Lee Jones | Counselor | 2628 Se 87th Ave, Portland, OR 97266-1530 | 2020-11-05 |
| 1356942221 | Joseph Cody Brainard | Physical Therapist | 4416 Ne Simpson St, Portland, OR 97218-1446 | 2020-11-05 |
| 1427659671 | Lindsay Marie Thomas | Doula | 4503 Se 66th Ave, Portland, OR 97206-4501 | 2020-11-04 |
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1063013373 | Ruth Tessema | Counselor | 2120 Ne 166th Dr, Portland, OR 97230-5558 | 2020-11-03 |
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1982204509 | Uchendu Ezra Iwuanyanwu | Occupational Therapy Assistant | 3550 S Bond Ave, Portland, OR 97239-4507 | 2020-11-01 |
| Find all providers in PORTLAND | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548399322 | Corporate Health Nw | Nurse Practitioner | 10209 Se Division St, Portland, OR 97266-1327 | 2007-03-05 |
| 1598301160 | Melissa Lohman | Nurse Practitioner | 6130 Ne 78th Ct Ste C10, Portland, OR 97218-4800 | 2019-11-19 |
| 1174170682 | Amy Samantha Peck | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-08-20 |
| 1235692484 | Ashley Chan | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2019-04-12 |
| 1871018119 | Matthew Sieg | Nurse Practitioner | 500 W Votaw St, Portland, IN 47371-1322 | 2017-08-08 |
| 1982056347 | Megan Lynne Black | Nurse Practitioner | 43 Baxter Blvd, Portland, ME 04101-1823 | 2016-07-11 |
| 1922463587 | Sarah Danford | Nurse Practitioner | 18000 Se Stark St, Portland, OR 97233 | 2015-12-28 |
| 1124401799 | Crystal Ward | Nurse Practitioner | 5100 Sw Macadam Ave, 200, Portland, OR 97239-6102 | 2015-07-01 |
| 1902166481 | Michele Jean Bergmann | Nurse Practitioner | 1040 Nw 22nd Ave, Ste 500, Portland, OR 97210-3057 | 2012-05-18 |
| 1336431154 | Chad Robinson | Nurse Practitioner | 2127 Nw Miller Rd, Portland, OR 97229-7501 | 2011-05-12 |
| Find all providers in PORTLAND | ||||
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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.