JOHN DUSTIN PENA


Address: 102 Courthouse Dr Ste F, Salmon, ID 83467-3905
Phone: 2087421110

JOHN DUSTIN PENA (NPI# 1730787482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730787482
Entity Type Individual
Full Name JOHN DUSTIN PENA
Credential FNP
Practice Address 102 Courthouse Dr Ste F
Salmon
ID 83467-3905
Mailing Address 508 Fulton St
Salmon
ID 83467-3850
Practice Telephone 2087421110
Practice Fax Number 2087421120
Mailing Telephone 2082413493
Enumeration Date 2020-10-14
Last Update Date 2020-10-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
65855 ID Physician Assistants & Advanced Practice Nursing Providers

Other Providers JOHN PENA

NPI Name Taxonomy Address Enumeration
1982962411 John Thomas Pena Student in an Organized Health Care Education/Training Program 1300 York Ave # 233, New York, NY 10065-4805 2012-05-03
1124366224 John Percival Pena Nurse Practitioner 1 Gustave L Levy Pl, New York, NY 10029-6500 2013-01-23
1700885373 John Joe Pena Physician Assistant 7950 Martin Loop, Fort Benning, GA 31905-5647 2005-07-18

Office Location

Street Address 102 COURTHOUSE DR STE F
City SALMON
State ID
Zip Code 83467-3905

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1962010686 Rocky Mountain Holdings, LLC Ambulance 17 Center Hangar Rd, Salmon, ID 83467 2020-07-20
1790204881 Annah Benedict Dahle Physical Therapist Porgy & Petunia's Pediatric Therapy 111 E Lillian, Suite 8, Salmon, ID 83467 2017-09-11
1912436395 Georgena Yanoff Occupational Therapist 516 Main Street #103, Salmon, ID 83467 2017-06-08
1134580525 Amy Berasi Specialist 201 Pole Line Rd, Salmon, ID 83467 2016-03-11
1689098964 Aspen Meadows Home Care LLC In Home Supportive Care 104 South Warpath, Salmon, ID 83467 2014-02-07
1366799827 Physical Therapy Clinic,inc. Clinic/Center 802 Shoup Street, Salmon, ID 83467 2012-08-14
1689826984 Charles John Clark Pharmacist 203 So. Daisy, Salmon, ID 83467 2008-10-17
1972767531 Katherine I Contway Social Worker 204 Courthouse Dr, Salmon, ID 83467 2008-07-14
1215135017 Annie J Allen Acupuncturist 111 Lillian Street, Suite 211, Salmon, ID 83467 2007-07-03
1992913479 Steele Memorial Medical Center Medicare Defined Swing Bed Unit 203 S. Daisy St., Salmon, ID 83467 2007-05-18
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548772338 Monica Lena White Nurse Practitioner 404 Courthouse Dr, Salmon, ID 83467-3341 2017-11-02
1285822692 Janet Merrell Nurse Practitioner 1911 Main St, Salmon, ID 83467-4512 2007-10-10
1427147511 Suzanne Nebeker Nurse Practitioner 805 Main St, Salmon, ID 83467-0000 2006-10-12
1669562716 Ruth K Campbell Nurse Practitioner 805 Main St, Salmon, ID 83467-0000 2006-10-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104427152 Christopher Alan Anthony Nicholas Nurse Practitioner 2889 N Chancery Pl, Meridian, ID 83646-7407 2020-11-05
1710588108 Lauren Proteau Nurse Practitioner 310 S Acer Loop, Post Falls, ID 83854-8809 2020-11-03
1568061398 Nicolette A Eberline Nurse Practitioner 4228 W Guard St Bldg 665, Boise, ID 83705-8049 2020-10-22
1023617347 Kristina Oliver Nurse Practitioner 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814-2668 2020-10-19
1982202743 Jayson Paul Smith Nurse Practitioner 1545 East Leighfield Dr., Meridian, ID 83646 2020-10-14
1659979516 Jennifer Anne Gardner Nurse Practitioner 1385 Park View Dr Ste 101, Twin Falls, ID 83301-4390 2020-10-13
1982210795 Samuel Hally Nurse Practitioner 1346 Cimarron Ct, Middleton, ID 83644-5894 2020-09-17
1013522275 Beau Lee Nurse Practitioner 2900 N Burton St, Boise, ID 83704-5314 2020-09-14
1649885534 Auston Whitmer Nurse Practitioner 2203 E Ringneck St, Meridian, ID 83646-7410 2020-09-09
1588277529 Tauna Marie Young Nurse Practitioner 1681 S Kimball Way, Boise, ID 83709-1654 2020-08-28
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Competitor

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City SALMON
Zip Code 83467

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Dataset Information

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.

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