SUSAN SAMPLE (NPI# 1316496565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316496565 |
| Entity Type | Individual |
| Full Name | SUSAN SAMPLE |
| Credential | NP |
| Practice Address |
700 N Westhaven Dr Oshkosh WI 54904 |
| Mailing Address |
700 N Westhaven Dr Oshkosh WI 54904-6947 |
| Practice Telephone | 9204562030 |
| Practice Fax Number | 9204562025 |
| Mailing Telephone | 9204562030 |
| Mailing Fax Number | 9204562025 |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2018-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 7300 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
7300-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
700 N WESTHAVEN DR |
| City | OSHKOSH |
| State | WI |
| Zip Code | 54904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326032335 | Stephen L Shopbell | Psychiatry & Neurology | 700 N Westhaven Dr, Oshkosh, WI 54904 | 2005-09-06 |
| 1598248890 | Julie A Paluch | Social Worker | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2018-09-12 |
| 1851887194 | Jennifer L Srnka | Social Worker | 700 N Westhaven Dr, Oshkosh, WI 54904 | 2018-07-10 |
| 1841719135 | Daniel John Thiel | Registered Nurse | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2017-09-18 |
| 1699127571 | Sandra Verhaeghe | Optometrist | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2016-07-05 |
| 1124465620 | Gregg Robert Brewer | Counselor | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2013-05-24 |
| 1992141246 | Dianne W Sellers | Nurse Practitioner | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2013-05-14 |
| 1255686416 | Lindsay W Davel | Nurse Practitioner | 700 N Westhaven Dr, Oshkosh, WI 54904 | 2012-07-13 |
| 1790045979 | Amy Leigh Parmley | Counselor | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2012-05-22 |
| 1255698551 | Gayle A Johnson | Counselor | 700 N Westhaven Dr, Oshkosh, WI 54904-6947 | 2012-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326567140 | Mary Kay Benotsch | Registered Nurse | 505 South Washburn Street, Oshkosh, WI 54904 | 2017-09-13 |
| 1295278356 | Braden Williams | Nurse Anesthetist, Certified Registered | 955 Pheasant Creek Dr, Oshkosh, WI 54904 | 2016-11-22 |
| 1740651330 | Ams of Wisconsin - Oshkosh | Clinic/Center | 595 South Washburn St, Oshkosh, WI 54904 | 2015-10-08 |
| 1174990253 | Kaochi Desjheannette Vang | Occupational Therapist | Aurora Medical Center of Oshkosh - Rehab, 855 N. Westhaven Drive, Oshkosh, WI 54904 | 2015-08-25 |
| 1326453200 | Chey V Collura | Surgery | 2700 W 9th Ave Ste 310, Oshkosh, WI 54904 | 2014-06-30 |
| 1275847543 | Eden Rehabilitation Suites and Green House Homes, Inc. | Skilled Nursing Facility | 3151 Eden Court, Oshkosh, WI 54904 | 2010-07-29 |
| 1700043502 | Eric Koehler | Physical Therapist | 3475 Omro Rd Ste 300, Oshkosh, WI 54904 | 2008-05-20 |
| 1831396167 | Angela Marie Wade | Behavioral Analyst | 2986 Fitchburg Ct., Oshkosh, WI 54904 | 2007-06-29 |
| 1174642383 | Michael Gerard Bell | Dentist | 1795 West Pointe Dr, Oshkosh, WI 54904 | 2007-03-28 |
| 1235253030 | Jessica Anne Bielmeier | Registered Nurse | 2700 West 9th Ave #125, Oshkosh, WI 54904 | 2007-03-19 |
| Find all providers in zip 54904 | ||||
| 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 |
|---|---|---|---|---|
| 1396399606 | Kurt Thomas | Nurse Practitioner | 1505 North Drive, Oshkosh, WI 54901 | 2019-07-25 |
| 1851575864 | Brooke Vanevenhoven | Nurse Practitioner | 220 Washington Ave, Oshkosh, WI 54901-5030 | 2007-12-27 |
| 1750425112 | Leona F Dempsey | Nurse Practitioner | 501 Merritt Ave, Oshkosh, WI 54901-5139 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422726 | Wisconsin Healthcare Family Practices and Behavioral Services LLC | Nurse Practitioner | 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 | 2020-09-17 |
| 1689292856 | Julianne Margaret John | Nurse Practitioner | 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 | 2020-07-13 |
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1932726700 | Lauren Marie Skemp | Nurse Practitioner | 1960 Hyview Rd, Cuba City, WI 53807-9718 | 2020-06-28 |
| 1235779240 | Conscious Practice, LLC | Nurse Practitioner | 119 19th St N, La Crosse, WI 54601-3724 | 2020-01-08 |
| 1073152161 | Stephanie L Ruskell | Nurse Practitioner | 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 | 2020-01-06 |
| 1558924811 | Sarah Kathryn Garven | Nurse Practitioner | 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 | 2019-04-22 |
| 1104394535 | Therese Ann Alm | Nurse Practitioner | 383 Williamstowne Ste 101, Delafield, WI 53018-2332 | 2018-11-03 |
| 1477079242 | Aeron Rachel Adams | Nurse Practitioner | W10237 Lake Emily Rd, Fox Lake, WI 53933 | 2017-08-14 |
| 1396140398 | Monica Gorski | Nurse Practitioner | 505 King St Ste 218, La Crosse, WI 54601-4289 | 2014-11-03 |
| Find all providers with the same taxonomy | ||||
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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.