JODI L SPACE (NPI# 1518217280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518217280 |
| Entity Type | Individual |
| Full Name | JODI L SPACE |
| Credential | APNP |
| Practice Address |
5416 Everybodys Rd Crandon WI 54520-8627 |
| Practice Telephone | 7154784890 |
| Mailing Telephone | 7154784890 |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |
| 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 |
5012-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5416 EVERYBODYS RD |
| City | CRANDON |
| State | WI |
| Zip Code | 54520-8627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447607031 | Casandra Jean Fleischman | Speech-Language Pathologist | 5416 Everybodys Rd, Crandon, WI 54520-8627 | 2016-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255574364 | Anne Morris Warren | Counselor | 5409 Everybody's Rd, Crandon, WI 54520 | 2009-04-20 |
| 1568643922 | Karen Mihalko | Hearing Instrument Specialist | 106 W Madison Street, Crandon, WI 54520 | 2007-11-14 |
| 1558379438 | David R Kaufman Jr. | Pharmacist | 5409 Everybodys Rd, Forest County Potwatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1114935095 | William R Pierre | Optometrist | 5409 Everbodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1285642165 | Christopher P Skaggs | Speech-Language Pathologist | 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| 1720033186 | Frank Mraz | Family Medicine | 5409 Everybody's Road, Crandon, WI 54520 | 2006-05-24 |
| 1770978173 | Lana Winter | Counselor | 3144 Vanzile Rd, Crandon, WI 54520 | 2015-04-02 |
| 1902221989 | Anna E Lopez | Massage Therapist | 8201 Mish Ko Swen Drive, Crandon, WI 54520 | 2014-02-27 |
| 1992959654 | Lisa M Miller | Dietitian, Registered | 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2008-11-07 |
| 1902814882 | Kirk R Ritchie | Dentist | 5409 Everybodys Road, Forest County Potawatomi Health & Wellness Center, Crandon, WI 54520 | 2006-08-04 |
| Find all providers in zip 54520 | ||||
| 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 |
|---|---|---|---|---|
| 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.