MS. DIANE M COCKBURN (NPI# 1275627325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275627325 |
| Entity Type | Individual |
| Full Name | MS. DIANE M COCKBURN |
| Credential | ANP |
| Practice Address |
875 Oak St Se Suite 4030 Salem OR 97301-3975 |
| Practice Telephone | 5035616444 |
| Practice Fax Number | 5035616440 |
| Mailing Telephone | 5035616444 |
| Mailing Fax Number | 5035616440 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 100111 | 05 |
| Street Address |
875 OAK ST SE SUITE 4030 |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952307498 | Jerry Leroy Hubbard | Neurological Surgery | 875 Oak St Se, Ste 5060, Salem, OR 97301-3987 | 2005-06-21 |
| 1710447453 | Katie Joy Larue | Pharmacist | 875 Oak St Se, Salem, OR 97301-3975 | 2019-03-20 |
| 1538600333 | Rachel Wixson | Nurse Practitioner | 875 Oak St Se, Salem, OR 97301-3975 | 2017-03-13 |
| 1265971386 | Angela Rehder | Physician Assistant | 875 Oak St Se, Suite 5020, Salem, OR 97301 | 2017-02-22 |
| 1548625585 | Hematology Oncology of Salem, LLP | Physician Assistant | 875 Oak St Se, Suite 4030, Salem, OR 97301-3975 | 2015-12-17 |
| 1841664752 | Healogics Specialty Physicians of Oregon, LLC | Emergency Medicine | 875 Oak St Se, Salem, OR 97301-3975 | 2015-11-17 |
| 1134592041 | Oregon Oncology Specialists, LLP | Internal Medicine | 875 Oak St Se, Suite 4030, Salem, OR 97301-3975 | 2015-11-02 |
| 1841693363 | Charles V. Hatchette II, Md, LLC | Neurological Surgery | 875 Oak St Se, Suite 5060, Salem, OR 97301-3975 | 2014-09-29 |
| 1770997009 | Urooba Faheem | Psychiatry & Neurology | 875 Oak St Se, Salem, OR 97301-3975 | 2014-06-14 |
| 1689922676 | Michael Christian Slabaugh | Physician Assistant | 875 Oak St Se, Ste 3010, Salem, OR 97301 | 2012-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124642673 | Andrea Danielle Stanley | Nurse Practitioner | 4232 Stanley Ln, Salem, VA 24153-4027 | 2020-06-01 |
| 1962912964 | Cornelius Bela | Nurse Practitioner | 5 Gables Cir, Salem, MA 01970-1217 | 2017-10-04 |
| 1164797536 | Corie Ann Shaevitz | Nurse Practitioner | 10550 Lake Dr Se, Salem, OR 97306-8107 | 2012-03-18 |
| 1134369184 | Anne Marie Stanton | Nurse Practitioner | Dove Ave, Northshore Medical Center Heart and Wellness Center, Salem, MA 01970 | 2009-03-04 |
| 1932244753 | Kristen Lynn Khanna | Nurse Practitioner | 95 Stiles Rd, Suite 107, Salem, NH 03079-4805 | 2007-02-20 |
| 1467512277 | Kimberly E Kintz | Nurse Practitioner | 195 Cottage St Se, Salem, OR 97301-3808 | 2006-12-11 |
| 1710050828 | Lauren M Sherlock | Nurse Practitioner | 6 Ravenna Ave, Salem, MA 01970-1722 | 2006-11-16 |
| 1295845964 | Patsy Louise Britt | Nurse Practitioner | 510 South Main, Salem, AR 72576 | 2006-08-30 |
| 1518978469 | Frances Lydia Howe | Nurse Practitioner | 2480 Liberty St Ne Ste 180, Salem, OR 97301-8388 | 2006-08-10 |
| 1982659926 | Ellen M Russell | Nurse Practitioner | 162 Federal St, Salem, MA 01970-3248 | 2006-05-24 |
| Find all providers in SALEM | ||||
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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.