BROOKE DAGER (NPI# 1164962379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164962379 |
Entity Type | Individual |
Full Name | BROOKE DAGER |
Other Name | BROOKE HALEY |
Practice Address |
670 Park Ave Shelby MT 59474-1663 |
Mailing Address |
670 Park Ave Po Box 990 Shelby MT 59474-1663 |
Practice Telephone | 4064343110 |
Mailing Telephone | 4064343110 |
Enumeration Date | 2017-03-07 |
Last Update Date | 2017-07-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
119094 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | AZ STATE RN LICENSE | 119094 | 01 |
MT | MONTANA LICENSE | 126668 | 01 |
Street Address |
670 PARK AVE |
City | SHELBY |
State | MT |
Zip Code | 59474-1663 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174526503 | Lance Lynn Stewart | Family Medicine | 670 Park Ave, Shelby, MT 59474-1663 | 2005-05-31 |
1700403201 | Paije E Gianarelli | Counselor | 670 Park Ave, Shelby, MT 59474-1663 | 2020-06-30 |
1932762515 | Marias Healthcare Services Inc | Durable Medical Equipment & Medical Supplies | 670 Park Ave, Shelby, MT 59474-1663 | 2019-04-18 |
1164988093 | Jodi L Habets | Nurse Practitioner | 670 Park Ave, Shelby, MT 59474-1663 | 2019-02-15 |
1578088548 | Dana L Hellinger | Counselor | 670 Park Ave, Shelby, MT 59474-1663 | 2017-08-10 |
1477088771 | Deborah Elizabeth Treece | Counselor | 670 Park Ave, Shelby, MT 59474-1663 | 2017-04-24 |
1750760815 | Tracy L Richman | Midwife | 670 Park Ave, Shelby, MT 59474-1663 | 2015-05-22 |
1043651235 | Joni M Walton | Nurse Practitioner | 670 Park Ave, Shelby, MT 59474-1663 | 2013-07-16 |
1013250950 | Justin Paul Hooker | Podiatrist | 670 Park Ave, Shelby, MT 59474 | 2013-03-28 |
1578827424 | Heidi Lynn Hunsucker | Nurse Practitioner | 670 Park Ave, Shelby, MT 59474-1663 | 2012-06-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518361559 | Scott Allen Luly | Dentist | 50 Crossroads Drive, Shelby, MT 59474 | 2014-10-20 |
1598710691 | Shopko Stores Operating Co LLC | Pharmacy | 1950 Roosevelt Hwy, Shelby, MT 59474-0920 | 2006-05-24 |
1659877538 | Jasmine Gonzaga | Registered Nurse | 943 Teton Ave, Shelby, MT 59474-1526 | 2018-04-01 |
1285184200 | Kyle Ann Kelsey Spinner | Pharmacist | 1950 W Roosevelt Hwy, Shelby, MT 59474-1549 | 2016-10-13 |
1659368512 | Toole County | Ambulance | 825 Oilfield Ave, Shelby, MT 59474-1642 | 2005-10-05 |
1669646238 | Shelby School District | Local Education Agency (LEA) | 1010 Oilfield Ave, Shelby, MT 59474-1647 | 2008-04-15 |
1245481159 | Marias Healthcare Services Inc | Clinic/Center | 13 1st St S, Sunburst, MT 59474-1663 | 2008-10-09 |
1780671834 | Toole County | Home Health | 640 Park Ave, Shelby, MT 59474-1663 | 2005-10-04 |
1659743441 | Empres At Shelby, LLC | Skilled Nursing Facility | 630 Park Ave, Shelby, MT 59474-1663 | 2015-10-20 |
1942467725 | Saint Patrick Hospital and Health Sciences Center | Internal Medicine | 640 Park Ave, Shelby, MT 59474-1663 | 2008-05-20 |
Find all providers in zip 59474 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437641578 | New Beginnings Health & Wellness | Nurse Practitioner | 1137 E Marion St, Shelby, NC 28150-4843 | 2018-06-05 |
1487184446 | Bryce David Yates | Nurse Practitioner | 615 S Dekalb St, Shelby, NC 28150-6184 | 2017-06-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053940791 | Christina Louise Borst | Nurse Practitioner | 124 Main Ave N, Choteau, MT 59422-9410 | 2020-04-04 |
1073142717 | Tommie L Perusich, PC | Nurse Practitioner | 209 S Montana St Ste B3, Butte, MT 59701-1645 | 2020-04-04 |
1043845142 | Samuel R Nave | Nurse Practitioner | 211 Flathead Ave, Bozeman, MT 59718-6339 | 2020-03-09 |
1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
1386288694 | David Charles Jansch | Nurse Practitioner | 400 Conley Lake Rd, Deer Lodge, MT 59722-8708 | 2019-10-30 |
1255992129 | Huston Psychiatric Services LLC | Nurse Practitioner | 1806 11th Ave, Helena, MT 59601-4768 | 2019-06-21 |
1235799032 | Jenna Lynn Belobraidic Kuru | Nurse Practitioner | 3131 Oliver St, Bozeman, MT 59718-6066 | 2019-06-14 |
1467016683 | Lovell Mental Health | Nurse Practitioner | 841 E Center St, Dillon, MT 59725-3211 | 2019-04-23 |
1023586377 | Eleanor Stacey Combs | Nurse Practitioner | 101 Ponderosa Dr, Butte, MT 59701-7318 | 2018-11-05 |
1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
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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.