ELISA DENISE GARRETT (NPI# 1811550866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811550866 |
| Entity Type | Individual |
| Full Name | ELISA DENISE GARRETT |
| Credential | AGNP-C |
| Practice Address |
675 N 5th St Lebanon OR 97355-2875 |
| Mailing Address |
Po Box 34 Sweet Home OR 97386-0034 |
| Practice Telephone | 5414516413 |
| Practice Fax Number | 5418122040 |
| Mailing Telephone | 8015439054 |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AG03190056 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
675 N 5TH ST |
| City | LEBANON |
| State | OR |
| Zip Code | 97355-2875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902865124 | Karen Elise Gaspardi | Obstetrics & Gynecology | 675 N 5th St, Lebanon, OR 97355-2875 | 2006-03-17 |
| 1174186068 | Lan Starkweather | Pharmacist | 675 N 5th St, Lebanon, OR 97355-2875 | 2019-04-17 |
| 1174041396 | Elena Noemi Noonan | Physician Assistant | 675 N 5th St, Lebanon, OR 97355-2875 | 2017-09-07 |
| 1972047488 | Devin Elizabeth Petschl | Nurse Practitioner | 675 N 5th St, Lebanon, OR 97355-2875 | 2016-12-19 |
| 1598217408 | Heather Diane Balzomo | Social Worker | 675 N 5th St, Lebanon, OR 97355-2875 | 2016-10-26 |
| 1689026759 | Hannah Mary Mcmahon Kadooka | Physician Assistant | 675 N 5th St, Lebanon, OR 97355-2875 | 2016-07-12 |
| 1346653722 | Robert Paulsen Michael | Pediatrics | 675 N 5th St, Lebanon, OR 97355-2875 | 2014-06-03 |
| 1245586767 | Kara Christine Mintier | Neuromusculoskeletal Medicine & OMM | 675 N 5th St, Lebanon, OR 97355-2875 | 2012-08-02 |
| 1902183619 | Jessica Barton | Lactation Consultant, Non-RN | 675 N 5th St, Lebanon, OR 97355-2875 | 2011-11-09 |
| 1699063784 | Mid-valley Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 675 N 5th St, Lebanon, OR 97355-2875 | 2011-07-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
| 1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
| 1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
| 1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
| 1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
| 1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
| 1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
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| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194295071 | Michelle Renee Singer | Nurse Practitioner | 1700 S Lincoln Ave, Lebanon, PA 17042-7529 | 2018-12-04 |
| 1871062505 | Lorraine A Sutphin | Nurse Practitioner | One Medical Center Drive, Lebanon, NH 03756-0001 | 2018-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558383430 | Nancy A Erb | Nurse Practitioner | 16209 W Hoffeldt Ln, Suite B, Brookings, OR 97415-9470 | 2006-07-23 |
| 1124058789 | Elizabeth Vonwellsheim | Nurse Practitioner | 382b South 58th Street, Springfield, OR 97478 | 2006-07-03 |
| 1568419091 | Carolyn Dolores Concia | Nurse Practitioner | 2308 Nw Stimpson Ln, Portland, OR 97229-8562 | 2006-05-30 |
| 1417581315 | Well Spring Health LLC | Nurse Practitioner | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2020-02-28 |
| 1821647173 | Haley Grace Ruljancich | Nurse Practitioner | 4010 Aerial Way, Eugene, OR 97402-9757 | 2019-09-10 |
| 1043862550 | Katherine Felicia Edstrom | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2019-07-15 |
| 1487216669 | Carolyn D Concia Np Prof Corp | Nurse Practitioner | 2308 Nw Stimpson Ln, Portland, OR 97229-8562 | 2019-07-08 |
| 1255800850 | Peter Woodring | Nurse Practitioner | 610 Hawthorne Ave Se Ste 110, Salem, OR 97301-5378 | 2018-11-13 |
| 1154809903 | Molly Christine Davis | Nurse Practitioner | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2018-08-03 |
| 1861926586 | Dashia Hewitt | Nurse Practitioner | 825 Bennett Ave, Medford, OR 97504-6715 | 2017-04-19 |
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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.