KELLIE MARIE CREASER (NPI# 1740821453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740821453 |
| Entity Type | Individual |
| Full Name | KELLIE MARIE CREASER |
| Credential | FNP |
| Practice Address |
500 5th St Brookings OR 97415-9702 |
| Practice Telephone | 5414122000 |
| Mailing Telephone | 5414122000 |
| Mailing Fax Number | 5414122081 |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201908534NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500771078 | 05 | |
| OR | CURRY MEDICAL CENTER NPI | 1083656367 | 01 |
| Street Address |
500 5TH ST |
| City | BROOKINGS |
| State | OR |
| Zip Code | 97415-9702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245226935 | Stephen W Shea | Orthopaedic Surgery | 500 5th St, Brookings, OR 97415-9702 | 2005-09-27 |
| 1174167555 | Brian Duncan Sinnott | Physician Assistant | 500 5th St, Brookings, OR 97415-9702 | 2019-10-29 |
| 1700440856 | Oregon Em-i Medical Services PC | Physician Assistant | 500 5th St, Brookings, OR 97415-9702 | 2019-04-24 |
| 1073070678 | Lacy Ann Woods | Occupational Therapist | 500 5th St, Brookings, OR 97415-9702 | 2019-03-01 |
| 1689195505 | Steven T. Brantingham | Podiatrist | 500 5th St, Brookings, OR 97415-9702 | 2017-06-30 |
| 1548701600 | Jackie B Michael-havens | Nurse Practitioner | 500 5th St, Brookings, OR 97415-9702 | 2017-03-09 |
| 1083088199 | Tiffanie Newman | Occupational Therapist | 500 5th St, Brookings, OR 97415-9702 | 2015-12-01 |
| 1538537469 | Oregon Em-i Medical Services PC | Physician Assistant | 500 5th St, Brookings, OR 97415-9702 | 2015-09-09 |
| 1457730632 | Harris Beach Emergency Physicians LLC | Emergency Medicine | 500 5th St, Brookings, OR 97415-9702 | 2015-05-21 |
| 1124443676 | Shana S Stark | Nurse Practitioner | 500 5th St, Brookings, OR 97415-9702 | 2014-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549575 | Christopher Scott Mayo Jr. | Denturist | 937 Chetco Ave Ste. B, Brookings, OR 97415 | 2020-02-12 |
| 1912564329 | Lori A Burkart | Speech-Language Pathologist | Curry Medical Ctr, 500 5th Street, Brookings, OR 97415 | 2019-05-21 |
| 1881144178 | Costa Clinical Psychology, LLC | Social Worker | 625 Spruce St., # 7666, Brookings, OR 97415 | 2016-10-11 |
| 1194173898 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 410 Maple St, Brookings, OR 97415 | 2016-06-03 |
| 1336595784 | Monica Shaw | Case Manager/Care Coordinator | 412 Alder, Brookings, OR 97415 | 2016-05-04 |
| 1639531437 | Ian Leonard | Behavioral Analyst | 450 Sb Chetco River Road, Brookings, OR 97415 | 2016-03-22 |
| 1518201151 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 210 Cove Lane, Brookings, OR 97415 | 2012-11-20 |
| 1699033365 | Sunlight Family Center, LLC | Clinic/Center | 604 Spruce Street, Brookings, OR 97415 | 2012-05-01 |
| 1649544784 | Oregon Coast Wellness Inc. | Clinic/Center | 648 Chetco Ave., Brookings, OR 97415 | 2012-03-07 |
| 1790072544 | Elizabeth A. Nation | Registered Nurse | 96343 Alder Ridge Road, Brookings, OR 97415 | 2011-06-30 |
| Find all providers in zip 97415 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619364742 | Tanya Llanque | Nurse Practitioner | 500 Main Ave Unit 883, Brookings, SD 57006-7647 | 2015-04-15 |
| 1821272790 | Debra Ann Burlage | Nurse Practitioner | Wellness Center 154, 2818, Brookings, SD 57007-0001 | 2007-12-27 |
| 1861538274 | Tracey S Kather | Nurse Practitioner | 97825 Shopping Center Ave., Brookings, OR 97415 | 2007-01-30 |
| 1285710616 | Brenda Fern Andersen | Nurse Practitioner | Sdsu Student Health Clinic, N. Campus Drive, Brookings, SD 57007-0001 | 2006-10-27 |
| 1194807511 | Lindsay Marie Rheault | Nurse Practitioner | Wellness Ctr, Box 2818, Brookings, SD 57007-0001 | 2006-10-19 |
| 1508802802 | Jennifer M. Boyle | Nurse Practitioner | 585 5th St, Brookings, OR 97415-9702 | 2006-06-22 |
| 1235170564 | Carol Oliver | Nurse Practitioner | 413 Mill Beach Rd, Brookings, OR 97415-9690 | 2006-06-09 |
| 1700873528 | Melissa Louise Wilson | Nurse Practitioner | 524 Spruce Street Unit 3, Brookings, OR 97415 | 2005-10-06 |
| 1568461804 | Janine Dawn Bassett | Nurse Practitioner | 400 22nd Ave, Brookings, SD 57006-2450 | 2005-07-19 |
| 1295731644 | Carla Dieter | Nurse Practitioner | Sdsu Health & Counseling Clinc, Brookings, SD 57007-0001 | 2005-06-21 |
| Find all providers in BROOKINGS | ||||
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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.