Provider Demographics
NPI:1104154301
Name:GOKEY, JAMIE E (CRNA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:E
Last Name:GOKEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:E
Other - Last Name:MARTENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:744 S WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3505
Mailing Address - Country:US
Mailing Address - Phone:920-433-3500
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:744 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3505
Practice Address - Country:US
Practice Address - Phone:920-433-3500
Practice Address - Fax:920-445-7289
Is Sole Proprietor?:No
Enumeration Date:2009-11-27
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4265-33367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000021105Medicare Oscar/Certification
WIK400125705Medicare Oscar/Certification