Active NPI
Patricia J. Haddeland, RN MN CPNP
- Pediatric Nurse Practitioner
- McMinnville, OR
National Provider Identifier
1336237486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 084054753N2
- Practice address
- 2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8862 - Phone
- (503) 472-6161
- Fax
- (503) 434-8498
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 084054753N2 | OR | Primary |
Addresses
Primary practice location
2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8862
Mailing address
2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8862
Phone (503) 472-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035035 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 084054753N2 | OR | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360713600000",
"number": "1336237486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2435 NE CUMULUS AVE STE A",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971288862",
"telephone_number": "503-472-6161",
"fax_number": "503-434-8498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2435 NE CUMULUS AVE STE A",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971288862",
"telephone_number": "503-472-6161",
"fax_number": "503-434-8498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADDELAND",
"first_name": "PATRICIA",
"middle_name": "J.",
"name_prefix": "Mrs.",
"credential": "RN MN CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2013-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OR",
"license": "084054753N2",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035035",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.