TATE COLTAN STAKER (NPI# 1184253585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184253585 |
| Entity Type | Individual |
| Full Name | TATE COLTAN STAKER |
| Practice Address |
1322 S 2nd E Rexburg ID 83440-3824 |
| Practice Telephone | 2087166982 |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1322 S 2ND E |
| City | REXBURG |
| State | ID |
| Zip Code | 83440-3824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235768490 | Henry's Fork Surgery Center Pllc | Clinic/Center | 23 Sawtelle Ave, Rexburg, ID 83440 | 2020-04-08 |
| 1952956906 | Shane Ellis Withers | Pharmacist | 164 E. Main, Rexburg, ID 83440 | 2019-08-06 |
| 1316392285 | Emma Anderson | Speech-Language Pathologist | 36 Professional Plaza Suite 110, Rexburg, ID 83440 | 2016-04-28 |
| 1851755524 | Sandra Frickey | Speech-Language Pathologist | 1087 Summers Drive, Premier Therapy Associates, Rexburg, ID 83440 | 2016-04-08 |
| 1275997215 | Kerry Denney | Counselor | 333 Walker Drive, Rexburg, ID 83440 | 2016-04-06 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1649692609 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 410 W 1st N, Rexburg, ID 83440 | 2014-01-10 |
| 1043652571 | Creed Simon Webster | Counselor | 30 S 2nd W, Rexburg, ID 83440 | 2013-07-25 |
| 1033461660 | James Cannon Allen Dds PC | Dentist | 106 E 1st North, Rexburg, ID 83440 | 2012-10-05 |
| 1417217316 | Shelby Dee Woolstenhulme | Speech-Language Pathologist | 450 E. Main Street, Rexburg, ID 83440 | 2012-05-24 |
| Find all providers in zip 83440 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013538883 | Corbin Curtis Wood | Student in an Organized Health Care Education/Training Program | 355 W 4650 N, Rexburg, ID 83440-3206 | 2020-05-02 |
| 1013367580 | Beth Agres | Student in an Organized Health Care Education/Training Program | 660 S 2nd W, Rexburg, ID 83440-2300 | 2016-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733694 | Susan L Boone | Student in an Organized Health Care Education/Training Program | 8506 W Donnybrook Dr, Boise, ID 83709-0606 | 2020-09-02 |
| 1003434283 | Luisa Broden | Student in an Organized Health Care Education/Training Program | 902 N Almon St Apt 3, Moscow, ID 83843-8544 | 2020-07-14 |
| 1255959003 | Daniel Isaiah Zebedeo | Student in an Organized Health Care Education/Training Program | 430 E Tiger Ave, Post Falls, ID 83854-6649 | 2020-07-08 |
| 1982229944 | Clayton Kline | Student in an Organized Health Care Education/Training Program | 881 E 3900 N, Buhl, ID 83316-5929 | 2020-06-15 |
| 1407476120 | Remington Sloan Farley | Student in an Organized Health Care Education/Training Program | 4015 E Florence Dr Apt 101, Meridian, ID 83642-6185 | 2020-04-22 |
| 1730715855 | Madison Hiatt | Student in an Organized Health Care Education/Training Program | 1209 W Targee St, Boise, ID 83706-4565 | 2020-03-20 |
| 1053946202 | Kaitlyn Casper | Student in an Organized Health Care Education/Training Program | 267 W Arrowrock Ln, Boise, ID 83706-4802 | 2020-03-09 |
| 1558996660 | Erik Malm | Student in an Organized Health Care Education/Training Program | 850 E Franklin Rd Ste 402, Meridian, ID 83642-8917 | 2020-03-09 |
| 1952955825 | Lani Jo Hernandez | Student in an Organized Health Care Education/Training Program | 6200 N River Pointe Dr Apt B203, Boise, ID 83714-1848 | 2019-07-30 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.