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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
65855 | ID | Physician Assistants & Advanced Practice Nursing Providers |
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 |
Street Address |
102 COURTHOUSE DR STE F |
City | SALMON |
State | ID |
Zip Code | 83467-3905 |
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 |
Find all providers in zip 83467 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
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 |
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 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on JOHN DUSTIN PENA.
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.