Provider Demographics
NPI:1518648344
Name:LEVERMAN, JOELEEN MARIE (PMHNP-BC, MSN, RN)
Entity type:Individual
Prefix:
First Name:JOELEEN
Middle Name:MARIE
Last Name:LEVERMAN
Suffix:
Gender:F
Credentials:PMHNP-BC, MSN, RN
Other - Prefix:
Other - First Name:JOELEEN
Other - Middle Name:MARIE
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1535 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4255
Mailing Address - Country:US
Mailing Address - Phone:971-720-1639
Mailing Address - Fax:
Practice Address - Street 1:1535 STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4255
Practice Address - Country:US
Practice Address - Phone:971-720-9639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201404126RN163W00000X
OR10034643363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse