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General NPI Number Information
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NPI Number | 1316756067
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Entity Type | Organization
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Legal Business Name | FRANCISCAN MEDICAL GROUP
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 4205 KITSAP WAY
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City | BREMERTON
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State | WA
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Zip | 98312-2447
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Country | US
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Telephone | 360-782-7780
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Fax | 360-782-7789
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Provider Business Mailing Address
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Address Line | PO BOX 31001-1518 ATTN: GOVERNMENT PAYER ENROLLMENT
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City | PASADENA
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State | CA
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Zip | 91110-1518
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Country | US
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Telephone | 253-779-6260
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Fax | 253-779-6294
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DAVID NOSACKA
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Credential |
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Telephone | 618-641-5468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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