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1548701600
JACKIE B MICHAEL-HAVENS
BROOKINGS, OR
NPI
1548701600
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: OR 202000081-NP-PP)
Enumeration Date
2017-03-09
Last Update Date
2020-09-03
Business Address
JACKIE B MICHAEL-HAVENS NP
500 5TH ST
BROOKINGS, OR 97415-9702
Phone number: 541-412-2000
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Mailing Address
JACKIE B MICHAEL-HAVENS NP
500 5TH ST
BROOKINGS, OR 97415-9702
Phone number: 541-412-2000
Copy
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