Misty Lynn Dehaven, APN in Rockford, IL - Medicare Nurse Practitioner

Misty Lynn Dehaven, APN is a medicare enrolled "Nurse Practitioner - Family" in Rockford, Illinois. She graduated from nursing school in 2018 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Freeport Regional Health Care Foundation and her current practice location is 1639 N Alpine Rd Ste 260, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 395-1500.

Misty Lynn Dehaven is licensed to practice in Illinois (license number 209018358) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003384603.

Contact Information

	Misty Lynn Dehaven, APN
	1639 N Alpine Rd Ste 260, Rockford, IL 61107-1481
	(815) 395-1500
	(815) 395-1415

Map and Direction

Provider's Profile

Full Name	Misty Lynn Dehaven
Gender	Female
Speciality	Nurse Practitioner
Experience	8 Years
Location	1639 N Alpine Rd Ste 260, Rockford, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Misty Lynn Dehaven graduated from nursing school in 2018

NPI Data:

NPI Number: 1003384603
Provider Enumeration Date: 11/13/2018
Last Update Date: 02/26/2019

Medicare PECOS Information:

PECOS PAC ID: 8729323498
Enrollment ID: I20181227002095

Medical Identifiers

Medical identifiers for Misty Lynn Dehaven such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003384603	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	209018358 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Fhn Memorial Hospital	Freeport, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Freeport Regional Health Care Foundation	9234041682	82

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Misty Lynn Dehaven allows following entities to bill medicare on her behalf.

Entity Name	Freeport Regional Health Care Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457337016 PECOS PAC ID: 9234041682 Enrollment ID: O20031104000182

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Misty Lynn Dehaven is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Misty Lynn Dehaven, APN Po Box 957, Rockford, IL 61105-0957 Ph: (815) 395-1500	Misty Lynn Dehaven, APN 1639 N Alpine Rd Ste 260, Rockford, IL 61107-1481 Ph: (815) 395-1500

Reviews and Comments

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Misty Lynn Dehaven, APN - Medicare Nurse Practitioner in Rockford, IL