MICHAEL BASTIEN NOWAK (NPI# 1801382494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801382494 |
| Entity Type | Individual |
| Full Name | MICHAEL BASTIEN NOWAK |
| Other Name | MIKE NOWAK |
| Practice Address |
751 Lombardi Ct Santa Rosa CA 95407-6798 |
| Mailing Address |
204 W 4th St Apt 13 Port Angeles WA 98362-2835 |
| Practice Telephone | 3607336114 |
| Mailing Telephone | 3607336114 |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2018-07-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 95164925 | CA | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | RN60149798 | WA | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP60864126 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95009174 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CA RN LISCENSE | 95164925 | 01 |
| CA | CA NURSE PRACTITIONER FURNISHING NUMBER | 95009174 | 01 |
| CA | CA APRN LICENSE NUMBER | 95009174 | 01 |
| WA | WA RN LISCENSE | RN60149798 | 01 |
| WA | WA APRN LICENSE NUMBER | AP60864126 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558360131 | Michael L Nowak | Obstetrics & Gynecology | 350 W Country Club Rd, Ste# 203, Roswell, NM 88201-5205 | 2005-07-18 |
| 1811991359 | Michael J Nowak | Physician Assistant | 1932 Alcoa Hwy Ste 270, Knoxville, TN 37920-1537 | 2005-06-13 |
| 1972845048 | Michael David Nowak | Pathology | 1425 Madison Ave Rm L9-52b, New York, NY 10029 | 2013-03-26 |
| 1417269853 | Michael Nowak | Pharmacist | 5000 W National Ave, Milwaukee, WI 53295-0001 | 2010-07-13 |
| 1255448940 | Michael Mark Nowak | Surgery | 12301 Snow Rd, Parma, OH 44130-1002 | 2006-08-25 |
| 1972570323 | Michael Anthony Nowak | Pathology | 4477 Medical Center Way, Suite B, West Palm Beach, FL 33407-3286 | 2006-03-03 |
| Street Address |
751 LOMBARDI CT |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95407-6798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831163716 | Tara Jeanine Budinger | Psychologist | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2006-02-15 |
| 1982214870 | Roxanne Patricia Schleben | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2020-08-05 |
| 1952932709 | Benjamin Robert Zumwalt | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2020-01-30 |
| 1114569878 | Daisy Ariana Lopez | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2019-10-15 |
| 1912463407 | Krystal Annie Bodily | Family Medicine | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2019-02-20 |
| 1205309580 | Daniel Christopher Lopez | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2019-01-09 |
| 1508334327 | Sharon Sneddon | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-11-09 |
| 1417458654 | Eleanna Alexia Kennedy | Nurse Practitioner | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-02-22 |
| 1336657204 | Lluriana Bailon | Registered Nurse | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2018-01-13 |
| 1316479850 | Arunima Kohli | Family Medicine | 751 Lombardi Ct, Santa Rosa, CA 95407-6798 | 2017-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100477 | Charrise Reece | Case Management | 935 S Davis, Santa Rosa, CA 95407 | 2020-10-07 |
| 1629687256 | Suzel Anne-marie Deer | Registered Nurse | 1017 Stony Point Rd, Santa Rosa, CA 95407 | 2020-07-29 |
| 1285152884 | Mercedes Zipperle | Specialist/Technologist | 638 Athena Pl, Santa Rosa, CA 95407 | 2017-09-03 |
| 1235664988 | Priceless Transport Care LLC | Non-emergency Medical Transport (VAN) | 661 Powderhorn Ave, Santa Rosa, CA 95407 | 2017-05-01 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1205207321 | Flaman Craig Mccloud Jr. | Counselor | 440 Arrowood Dr., Santa Rosa, CA 95407 | 2015-10-15 |
| 1548679400 | Jill Bauer | Dental Hygienist | 2740 Ironstone Circle, Santa Rosa, CA 95407 | 2014-08-05 |
| 1922413673 | Aurora Alejandra Gomez Selpides | Family Medicine | 2240 Mercury Way, Santa Rosa, CA 95407 | 2014-06-20 |
| 1508159955 | Luis Angel Gonzalez | Counselor | 1202 Apollo Way, Santa Rosa, CA 95407 | 2011-05-18 |
| 1326286295 | Kelly Alexis Rathmann | Social Worker | 3650 Standish Avenue, Santa Rosa, CA 95407 | 2009-01-29 |
| Find all providers in zip 95407 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780160234 | Susan English Knowles | Nurse Practitioner | 3383 Airway Dr, Santa Rosa, CA 95403-2005 | 2018-07-18 |
| 1912498726 | Lydia Ann Smith | Nurse Practitioner | 2375 Range Ave Unit 1, Santa Rosa, CA 95403-9419 | 2018-05-29 |
| 1659870186 | Shannon Cross Todd | Nurse Practitioner | 4729a Hoen Ave, Santa Rosa, CA 95405-7862 | 2018-02-11 |
| 1093222408 | Mary Esther Andich | Nurse Practitioner | 2800 Cleveland Ave Ste A, Santa Rosa, CA 95403-2784 | 2018-01-08 |
| 1316473697 | Renee Novakovich | Nurse Practitioner | 704 Adobe Dr, Santa Rosa, CA 95404-2706 | 2017-05-05 |
| 1780139634 | Robin Shank Sanderson | Nurse Practitioner | 751 Lombardi, Santa Rosa, CA 95407 | 2016-08-22 |
| 1437549235 | Jennifer Takagi | Nurse Practitioner | 1803 Aspen Leaf Ln, Santa Rosa, CA 95401-4295 | 2015-01-31 |
| 1164828828 | Danielle J Daye | Nurse Practitioner | 50 Montgomery Dr, Santa Rosa, CA 95404-6615 | 2014-11-07 |
| 1609208354 | Derrick Pelton | Nurse Practitioner | 2360 Mendocino Ave Ste A4, Santa Rosa, CA 95403-3154 | 2013-08-05 |
| 1225313869 | Kristine Monson Brown | Nurse Practitioner | 1501 Mendocino Ave, Santa Rosa, CA 95401-4332 | 2011-10-14 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95407 |
Please comment or provide details below to improve the information on MICHAEL BASTIEN NOWAK.
| 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.