Jennah A.L. Haque, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8713-33 Issued in WI

Practice address

2641 Development Dr
Green Bay, WI 54311-4240

Phone

(920) 338-6868

Fax

(920) 338-6869

NPI assigned

Jun 27, 2018

Last updated

Mar 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jenna A Landwehr Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhaque924600@direct.emplifyhealth.org

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

• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  dba Neurology Consultants of Bellin Health

  • Neurology Physician
  • Green Bay, WI
  • NPI 1225420664
  NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health Generations

  • Clinic/Center
  • Green Bay, WI
  • NPI 1497191951
  NPD (past)
• Bellin Memorial Hospital Inc

  dba FMC Brillion

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1902391410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 DEVELOPMENT DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114240",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 S VanBuren St",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013504",
            "country_code": "US",
            "telephone_number": "920-433-3420",
            "fax_number": "920-433-3788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1688 N CasalomaDr",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549138245",
            "country_code": "US",
            "telephone_number": "920-775-5105",
            "fax_number": "920-338-6869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013528",
            "country_code": "US",
            "telephone_number": "920-338-6868",
            "fax_number": "920-338-6869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAQUE",
        "first_name": "JENNAH",
        "middle_name": "A.L.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "223532-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8713-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "LANDWEHR",
            "middle_name": "A",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark H Hanson, DDS MS
• Meghan E. Hanson, M.D.
• Rebecca Busch Hanson, LPC
• Maria Catherine Hanstedt, MA, CCC/SLP
• Ravindra Hanumaiah, M.D.
• Kara H Harbick, MD
• Harbor Community Psychological Associates SC
• Harbor Health and Wellness LLC
• Lourica Ellis Hardin, HEALTH EDUCATOR
• Judith A Harding, APNP

• Family Nurse Practitioner in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.