SUSAN M JACQUEZ-DEAN (NPI# 1659482339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659482339 |
| Entity Type | Individual |
| Full Name | SUSAN M JACQUEZ-DEAN |
| Credential | M.D |
| Practice Address |
1160 Kepler Dr 2nd Floor Green Bay WI 54311-8321 |
| Practice Telephone | 9202885630 |
| Practice Fax Number | 9202885439 |
| Mailing Telephone | 9202885630 |
| Mailing Fax Number | 9202884539 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
45956-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34440300 | 05 |
| Street Address |
1160 KEPLER DR 2ND FLOOR |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54311-8321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649273129 | Luke Thomas Warpinski | Family Medicine | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2005-05-27 |
| 1639783202 | Angela Dhuey | Massage Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2020-09-01 |
| 1912511585 | Marilee Petasek | Massage Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2020-09-01 |
| 1720611981 | Baycare Aurora, LLC | Durable Medical Equipment & Medical Supplies | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2020-02-17 |
| 1619448727 | Melissa Mary Thompson | Physical Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-12-16 |
| 1942776919 | Nathan Seitz | Physical Therapist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-10-17 |
| 1679052104 | Amy E Warden | Nurse Practitioner | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-08-07 |
| 1477052553 | Kristin Kiekhaefer | Specialist/Technologist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-02-05 |
| 1235647876 | Jordan Robinson | Specialist/Technologist | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2018-01-17 |
| 1811433816 | Paige E Pernaski | Registered Nurse | 1160 Kepler Dr, Green Bay, WI 54311-8321 | 2017-01-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333847 | Karen Ginnow | Pharmacist | Walmart #1908, 2292 Main St, Green Bay, WI 54311 | 2020-10-15 |
| 1639786551 | Maggie Hall | Dental Hygienist | 2633 Development Dr. Ste 40, Green Bay, WI 54311 | 2020-09-24 |
| 1295370807 | Jennifer Marie Arendt | Technician | 2970 Mossy Oak Cir #39, Green Bay, WI 54311 | 2019-11-07 |
| 1518508803 | Cheryl Ann Johnson | Specialist | 830 Edgewood Dr., Green Bay, WI 54311 | 2019-10-08 |
| 1124670898 | Robert H Wagner Family Dentist S.c. | Dentist | 2830 Curry Court, Suite 1, Green Bay, WI 54311 | 2019-07-12 |
| 1821659624 | The Salvation Army | Counselor | The Salvation Army Ray & Joan Kroc Center, 1315 Lime Kiln Road, Green Bay, WI 54311 | 2019-06-24 |
| 1578052866 | Matthew Robert Wagner | Dentist | 2830 Curry Ln #1, Green Bay, WI 54311 | 2018-05-02 |
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
| 1710382809 | Betsy Hoida | Pharmacist | 2485 Greenbrier Rd., Green Bay, WI 54311 | 2014-10-31 |
| Find all providers in zip 54311 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083871503 | Anima Family Counseling, LLC | Psychiatry & Neurology | 2475 University Ave, Suite A, Green Bay, WI 54302-5099 | 2008-05-21 |
| 1073662938 | Shelley Boehm Mattia | Psychiatry & Neurology | 428 Doty Street, Green Bay, WI 54301 | 2007-01-09 |
| 1386750115 | Peter M Fischer | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2006-08-22 |
| 1043295256 | George D Soncrant | Psychiatry & Neurology | 3000 Riverside Dr, Suite 180, Green Bay, WI 54301-1653 | 2005-12-09 |
| 1295226512 | Pyramid Psychiatric Care, LLC | Psychiatry & Neurology | 2475 University Ave Ste A, Green Bay, WI 54302-5099 | 2018-05-22 |
| 1861993172 | Sbh-green Bay, LLC | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2018-02-22 |
| 1629513973 | Verstehen, LLC | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311-8302 | 2016-12-22 |
| 1922556778 | Sbh-green Bay, LLC | Psychiatry & Neurology | 1351 Ontario Rd, Green Bay, WI 54311 | 2016-09-21 |
| 1033406038 | Emily R Rademacher | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2011-06-29 |
| 1457662249 | David M Mcmahon | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2010-06-25 |
| 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.