Provider Demographics
NPI:1700556511
Name:JAMESEN BIRKEL PMHNP, LLC
Entity Type:Organization
Organization Name:JAMESEN BIRKEL PMHNP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER (PMHNP)
Authorized Official - Prefix:
Authorized Official - First Name:JAMESEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BIRKEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-869-5458
Mailing Address - Street 1:36412 PARADISE CIR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:CO
Mailing Address - Zip Code:80107-8818
Mailing Address - Country:US
Mailing Address - Phone:316-869-5458
Mailing Address - Fax:
Practice Address - Street 1:401 BROADWAY
Practice Address - Street 2:SUITE 100 PMB 92554
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402
Practice Address - Country:US
Practice Address - Phone:316-869-5458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty