CAITLEN ELIZABETH DESPAIN (NPI# 1588186084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588186084 |
Entity Type | Individual |
Full Name | CAITLEN ELIZABETH DESPAIN |
Credential | FNP-BC |
Practice Address |
610 N Westgate Ave Jacksonville IL 62650-1152 |
Practice Telephone | 2172438455 |
Practice Fax Number | 2172437951 |
Mailing Telephone | 2172438455 |
Mailing Fax Number | 2172437951 |
Enumeration Date | 2017-07-17 |
Last Update Date | 2019-10-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
209-016174 | IL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | STATE LICENSE | 209-016174 | 01 |
Street Address |
610 N WESTGATE AVE |
City | JACKSONVILLE |
State | IL |
Zip Code | 62650-1152 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598727620 | Jeffrey L Olejnik | Obstetrics & Gynecology | 610 N Westgate Ave, Jacksonville, IL 62650 | 2006-04-04 |
1053804443 | Siu Physicians & Surgeons, Inc | Clinic/Center | 610 N Westgate Ave, Jacksonville, IL 62650-1152 | 2018-06-11 |
1780726430 | Alexander M Hrynewych | Obstetrics & Gynecology | 610 N Westgate Ave, Jacksonville, IL 62650 | 2007-02-12 |
1619993565 | Tracy Hendricks | Family Medicine | 610 N Westgate Ave, Jacksonville, IL 62650-1152 | 2006-07-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
Find all providers in zip 62650 |
Taxonomy Code | 363LX0001X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Obstetrics & Gynecology |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962895326 | University of Florida Jacksonville Physicians Inc | Nurse Practitioner | 15255 Max Leggett Pkwy Ste 4600, Ufjp - Uf Health Birth Center, Jacksonville, FL 32218-7213 | 2015-03-10 |
1811324965 | Dalia Philbeck | Nurse Practitioner | 15255 Max Leggett Pkwy Ste 4400, Jacksonville, FL 32218-7273 | 2013-10-03 |
1386856649 | Victoria L Kell | Nurse Practitioner | 247 Memorial Dr, Jacksonville, NC 28546-6333 | 2007-05-07 |
1033284922 | Maureen C Baxter | Nurse Practitioner | 815 Plaza, Jacksonville, FL 32233 | 2006-11-24 |
1477625457 | Evelyn Knoblock Brady | Nurse Practitioner | 4311 Salisbury Rd, Jacksonville, FL 32216-6123 | 2006-11-14 |
1982628798 | Glenda A. Phillips | Nurse Practitioner | 8075 Gate Pkwy W Ste 305, Jacksonville, FL 32216-3685 | 2006-07-26 |
1831145713 | Nancy R Robinson | Nurse Practitioner | 2933 University Blvd. North, Jacksonville, FL 32211 | 2006-05-25 |
1437104692 | Donna S Price | Nurse Practitioner | 5300 North Pearl Street, Jacksonville, FL 32208 | 2006-05-24 |
1538773304 | Joymarie Jennifer Steely | Nurse Practitioner | 13241 Bartram Park Blvd Unit 1509, Jacksonville, FL 32258-5231 | 2020-08-31 |
1417297854 | Katelyn Lee Bryant | Nurse Practitioner | 14546 Old Saint Augustine Rd Ste 305&311, Jacksonville, FL 32258-5468 | 2013-02-21 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 62650 |
Please comment or provide details below to improve the information on CAITLEN ELIZABETH DESPAIN.
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.