ELAINE M SMITH (NPI# 1285684662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285684662 |
| Entity Type | Individual |
| Full Name | ELAINE M SMITH |
| Credential | PA |
| Practice Address |
301 Bay Park Sq Green Bay WI 54304-5104 |
| Practice Telephone | 9205929475 |
| Mailing Telephone | 9205929475 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1317 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39842400 | 05 | |
| WI | LICENSE | 1317-023 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912466558 | Elaine Lynette Smith | Student in an Organized Health Care Education/Training Program | 220 W Princeton Ave, Gilbert, AZ 85233-3310 | 2019-03-13 |
| 1093170631 | Elaine Smith | Counselor | 42 164th St, Calumet City, IL 60409-6008 | 2015-12-28 |
| 1730575283 | Elaine Smith | Emergency Medicine | 1020 Sansom St Ste 1651b, Philadelphia, PA 19107-5002 | 2015-04-11 |
| 1508155094 | Elaine L Smith | Pharmacist | 1712 Alden Ln, Wyomissing, PA 19610-1165 | 2011-04-05 |
| 1447411368 | Elaine Smith | Occupational Therapist | 390 North Market Street Extended, Seaford, DE 19973-2612 | 2008-06-23 |
| 1447472618 | Elaine Show Smith | Registered Nurse | 760 Piegan St, Browning, MT 59417 | 2007-05-03 |
| 1336263474 | Elaine Elena Smith | Counselor | 401 Apache Rd, Houma, LA 70360-6040 | 2007-03-16 |
| 1679678932 | Elaine L. Smith | Nurse Practitioner | 3580 Lyon Dr, Lexington, KY 40513-1210 | 2006-09-13 |
| 1568575124 | Elaine G Smith | Social Worker | 110 Manly Street, Greenville, SC 29601 | 2006-08-17 |
| 1972523231 | Elaine Susan Smith | Nurse Practitioner | 465 N Union St, Olean, NY 14760-2658 | 2006-07-20 |
| Street Address |
301 BAY PARK SQ |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-5104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174089528 | Britny L Babler | Nurse Practitioner | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2019-02-11 |
| 1811349970 | Marissa Leigh Zehren | Nurse Practitioner | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2016-07-12 |
| 1689080277 | Kris L Barrette | Registered Nurse | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2014-07-03 |
| 1932521945 | Jeffrey Allen Maurer | Physician Assistant | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2014-01-09 |
| 1962833301 | Gena Trast | Pharmacist | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2013-12-11 |
| 1629409099 | Thomas Boucher | Pharmacist | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2013-12-10 |
| 1184051948 | Shopko | Pharmacy | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2013-10-10 |
| 1558615047 | Alisyn R Baciak | Pharmacist | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2012-11-05 |
| 1376832451 | Sabrina Rhea Spets | Registered Nurse | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2011-03-29 |
| 1861641516 | Rachael A Cabral Guevara | Nurse Practitioner | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2008-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700253101 | Mathias Dahnert | Physician Assistant | 945 S Irwin Ave, Green Bay, WI 54301-3309 | 2015-09-01 |
| 1770992067 | Sheila M Teddy | Physician Assistant | 2595 Development Dr Ste 150, Green Bay, WI 54311-4288 | 2014-08-12 |
| 1245652718 | Bailey Bauer | Physician Assistant | 2753 Mayline Dr, Green Bay, WI 54311-9646 | 2014-01-17 |
| 1588949333 | Carissa Ann Coorough | Physician Assistant | 720 S Van Buren St Ste 301, Green Bay, WI 54301-3534 | 2011-10-12 |
| 1093942047 | Taresa B Fassbender | Physician Assistant | 3263 Eaton Rd Ste 1, Green Bay, WI 54311-6830 | 2009-06-17 |
| 1265628507 | Colleen M Van Egeren | Physician Assistant | 715 Superior Rd, Suite 120, Green Bay, WI 54311-7594 | 2007-09-20 |
| 1427079516 | Dermatology Clinic S.c. | Physician Assistant | 715 Superior Rd Ste 120, Green Bay, WI 54311-7595 | 2006-07-22 |
| 1316976814 | Kevin F Nelson | Physician Assistant | 3237 Voyager Dr, Green Bay, WI 54311-8349 | 2006-06-30 |
| 1841233186 | Randall R Southards | Physician Assistant | 2845 Greenbrier Rd Ste 320, Green Bay, WI 54311-6519 | 2006-06-14 |
| 1184609331 | Penny S Cornelius | Physician Assistant | 2618 Forestville Dr, Green Bay, WI 54304-1358 | 2005-12-09 |
| Find all providers in GREEN BAY | ||||
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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.