MRS. JACQUELYN RENE FORSSBERG (NPI# 1043628233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043628233 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELYN RENE FORSSBERG |
| Credential | APRN |
| Practice Address |
1021 Eisenhower Ave Great Bend KS 67530 |
| Mailing Address |
592 Terrace Dr Pratt KS 67124-3213 |
| Practice Telephone | 6207925437 |
| Mailing Telephone | 9139085225 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
53-76350-092 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1021 EISENHOWER AVE |
| City | GREAT BEND |
| State | KS |
| Zip Code | 67530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669450847 | Marta J Edmonds | Pediatrics | 1021 Eisenhower Ave, Great Bend Children's Clinic, P.a., Great Bend, KS 67530-3213 | 2006-01-06 |
| 1417190331 | Harimahefa Ratsimbason | Pediatrics | 1021 Eisenhower Ave, Great Bend, KS 67530-3213 | 2009-04-07 |
| 1003089160 | Christopher Joseph Koster | Pediatrics | 1021 Eisenhower Ave, Great Bend, KS 67530-3213 | 2008-04-09 |
| 1861457194 | Susan J Bauer | Nurse Practitioner | 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530-3213 | 2006-04-19 |
| 1659336980 | Karen M Norris | Nurse Practitioner | 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530-3213 | 2006-04-19 |
| 1730167842 | Ryan M Williams | Pediatrics | 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530-3213 | 2006-01-09 |
| 1619955853 | Great Bend Childrens Clinic Pa | Clinic/Center | 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530-3213 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488048 | Taryn Mitchell | Pharmacist | 3910 10th St, Great Bend, KS 67530 | 2020-08-18 |
| 1972113678 | Sarah Schenek | Counselor | 1819 11th Street, Great Bend, KS 67530 | 2020-08-06 |
| 1407471840 | Joanne Renee Wondra | Counselor | 801 Patton Road, Great Bend, KS 67530 | 2020-06-11 |
| 1144852302 | Rosenberg Dentistry: Joe Rosenberg Dds. Pa | Dentist | 1037 Sheridan Suite D, Great Bend, KS 67530 | 2020-02-06 |
| 1265895908 | Kayti Trapp | Physical Therapy Assistant | 1514 Ks-96 Hwy, Great Bend, KS 67530 | 2016-03-31 |
| 1083732069 | Drew Andrew Hosman Sr. | Counselor | 1105 Main St Ste D, Great Bend, KS 67530 | 2007-03-27 |
| 1912060435 | Larry G Kutina | Dentist | 3820 6th Street, Great Bend, KS 67530 | 2006-12-18 |
| 1144308883 | Hcc-healthcare of Great Bend, LLC | Skilled Nursing Facility | 1560 K96 Highway, Great Bend, KS 67530 | 2006-11-01 |
| 1841370699 | Edward Lake Jones | Pathology | 2001 Lincoln, Great Bend, KS 67530 | 2006-10-16 |
| 1407955529 | William G Hafner | Chiropractor | 1309 Williams St., Great Bend, KS 67530 | 2006-09-22 |
| Find all providers in zip 67530 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861457194 | Susan J Bauer | Nurse Practitioner | 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530-3213 | 2006-04-19 |
| 1659336980 | Karen M Norris | Nurse Practitioner | 1021 Eisenhower Ave, Great Bend Children's Clinic, Great Bend, KS 67530-3213 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689283889 | Larisa Dawn Reida | Nurse Practitioner | 3049 Sw Rustic Rd, Benton, KS 67017-9159 | 2020-07-24 |
| 1447724653 | Kristen Michelle Wastler | Nurse Practitioner | 8340 Mission Rd Ste 100, Prairie Village, KS 66206-1367 | 2019-01-22 |
| 1336643691 | Jennifer Whitney Jensen | Nurse Practitioner | 1010 N Kansas St Ste 3054, Wichita, KS 67214-3124 | 2018-03-21 |
| 1831546423 | Danielle Elizabeth Berg | Nurse Practitioner | 29475 W 189th Ter, Gardner, KS 66030-9428 | 2016-05-24 |
| 1255564357 | Stacey D. Howell | Nurse Practitioner | 550 N. Hillside, Ku Wichita Pediatric Hospitalists, Wichita, KS 67214 | 2009-08-24 |
| 1962623058 | Julie Lynne Thorne | Nurse Practitioner | 21 N 12th St Ste 300, Kansas City, KS 66102-5105 | 2007-05-02 |
| 1922159656 | Harriett Currie Navarre | Nurse Practitioner | 4313 State Ave, Kansas City, KS 66102-3734 | 2007-01-16 |
| 1316004765 | Ruth H Oliverson | Nurse Practitioner | 9825 E Shannon Woods Cir, Wichita, KS 67226-4100 | 2007-01-03 |
| 1598825515 | Angela Marie Harrish | Nurse Practitioner | 5250 West 94th Terrace, Prairie Village, KS 66207 | 2006-12-11 |
| 1407869126 | Sharon R Tyson | Nurse Practitioner | 9825 E Shannon Woods, Wichita, KS 67226-4100 | 2006-08-14 |
| Find all providers with the same taxonomy | ||||
| City | GREAT BEND |
| Zip Code | 67530 |
Please comment or provide details below to improve the information on MRS. JACQUELYN RENE FORSSBERG.
| 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.