Roxann Jean Hackbarth

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Milford, IA

NPI 1124301023 · NPPES record last updated Jun 19, 2015

Key facts

NPI
1124301023
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
G-092068 (IA)
Practice address
1004 21St St
Suite #3
Milford, IA 51351-7421
Phone
(712) 338-6911
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
G-092068IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Iowa Mental Health Center Past Accepting new patients
Northwest Iowa Mental Health Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G-092068 IA Yes

Addresses

Primary practice location

1004 21St St
Suite #3
Milford, IA 51351-7421

Mailing address

PO Box 207
Suite #3
Milford, IA 51351-0207

Other providers in Milford, IA

All providers in Milford, IA · Psychiatric/Mental Health Nurse Practitioner in Iowa

Sources for this page

Verify at the official NPI Registry.