JULIE R. STACKHOUSE (NPI# 1942352802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942352802 |
| Entity Type | Individual |
| Full Name | JULIE R. STACKHOUSE |
| Other Name | JULIE R. MITCHENER |
| Credential | CNM |
| Practice Address |
2414 E State Blvd Suite 101 Fort Wayne IN 46805-4760 |
| Mailing Address |
6920 Pointe Inverness Way Ste 200 Fort Wayne IN 46804-7934 |
| Practice Telephone | 2604227455 |
| Practice Fax Number | 2604220086 |
| Mailing Telephone | 2604793516 |
| Mailing Fax Number | 2604793520 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71001177A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367A00000X | Advanced Practice Midwife | 09000127A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200847020 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447275268 | Julie Stackhouse | Physician Assistant | 1528 Eureka Rd Ste 103, Roseville, CA 95661-3047 | 2006-07-13 |
| Street Address |
2414 E STATE BLVD SUITE 101 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-4760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639171499 | John R Stanford | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2414 E State Blvd, Carew Building #1, Suite 201, Fort Wayne, IN 46805-4760 | 2005-08-11 |
| 1831354471 | Northeast Obstetrics & Gynecology, LLC | Obstetrics & Gynecology | 2414 E State Blvd, Suite 101, Fort Wayne, IN 46805-4760 | 2008-07-23 |
| 1558529933 | Cheryl Amanda Gratz | Social Worker | 2414 E State Blvd, Suite 304, Fort Wayne, IN 46805-4760 | 2008-06-02 |
| 1972594968 | Allied Physicians Inc., D/b/a Indiana Ohio Heart | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2414 E State Blvd, Carew Building, Fort Wayne, IN 46805-4760 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394599 | Laury Farrell | Nurse Practitioner | 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 | 2020-10-22 |
| 1730787599 | Crystal Neal | Nurse Practitioner | 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 | 2020-10-14 |
| 1225668312 | Kathleen Vanderreyden | Nurse Practitioner | 3005 E State Blvd, Fort Wayne, IN 46805-4736 | 2020-01-17 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1275980690 | April Anderson | Nurse Practitioner | 6920 Pointe Inverness Way Ste 120, Fort Wayne, IN 46804-7926 | 2016-05-16 |
| 1922470970 | Jennifer Carol Littke | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2015-10-28 |
| 1275956054 | Andrea N Lahrman | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 106, Fort Wayne, IN 46845-1707 | 2014-01-29 |
| 1417213729 | Laura Beth Baker | Nurse Practitioner | 5750 Falls Drive, Fort Wayne, IN 46804-7147 | 2012-04-11 |
| 1447572441 | Kathryn L Smith | Nurse Practitioner | 11104 Parkview Circle Dr Ste 20, Fort Wayne, IN 46845-1733 | 2010-02-18 |
| 1316180144 | Braden M Butterfield Mckinley | Nurse Practitioner | 2101 E Coliseum Blvd Rm 234, Fort Wayne, IN 46805-1445 | 2009-04-09 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on JULIE R. STACKHOUSE.
| 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.