HOPE MENTAL WELLNESS NPI 1083321400

NPI Information

NPI: 1083321400
Provider Name: HOPE MENTAL WELLNESS

Former Legal Business Name: HOPE MENTAL WELLNESS LLC

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
632 ANDERSON AVE
COOS BAY, OR
ZIP 97420
Phone: (541) 236-2086
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HOPE MENTAL WELLNESS is a psychiatric/mental health nurse practitioner in Coos Bay, OR. HOPE MENTAL WELLNESS NPI is 1083321400. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Hope Mental Wellness Llc.

The provider's business location address is:

632 ANDERSON AVE
COOS BAY, OR
ZIP 97420-632
Phone: (541) 236-2086
Fax: (541) 214-2897

The provider's authorized official is Jennifer Dawn Hope .
The authorized official title is Sole Proprietor/practitioner and has the following contact phone number (541) 236-2086.

The enumeration date for this NPI number is 11/4/2022 and was last updated on 8/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500794087	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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