KUNA FAMILY MEDICAL CLINIC, P. A. (NPI# 1740326990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740326990 |
| Entity Type | Organization |
| Organization Name | KUNA FAMILY MEDICAL CLINIC, P. A. |
| Practice Address |
708 E Wythe Creek Ct Ste 103 Kuna ID 83634-5005 |
| Mailing Address |
Po Box 68 Kuna ID 83634-0068 |
| Practice Telephone | 2089225130 |
| Practice Fax Number | 2089225132 |
| Mailing Telephone | 2089225130 |
| Mailing Fax Number | 2089225132 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-12-02 |
| Authorized Official Name | MRS. MYRNA C. FISHER (OWNER) |
| Authorized Official Telephone | 2089225130 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
NP193A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 804073900 | 05 |
| Street Address |
708 E WYTHE CREEK CT STE 103 |
| City | KUNA |
| State | ID |
| Zip Code | 83634-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134500515 | Amanda Berbert | Family Medicine | 708 E Wythe Creek Ct Ste 103, Kuna, ID 83634 | 2015-06-11 |
| 1003296724 | Molly M Mccormick | Family Medicine | 708 E Wythe Creek Ct Ste 103, Kuna, ID 83634-5005 | 2015-06-08 |
| 1184930976 | Darrel Robert Porr | Family Medicine | 708 E Wythe Creek Ct Ste 103, Kuna, ID 83634-5005 | 2010-08-31 |
| 1982832176 | Sarah G. Gerrish | Family Medicine | 708 E Wythe Creek Ct Ste 103, Kuna, ID 83634-5005 | 2009-06-25 |
| 1003067984 | Annie Johnson | Physician Assistant | 708 E Wythe Creek Ct Ste 103, Kuna, ID 83634-5005 | 2008-10-09 |
| 1841318276 | Douglas Kent Mcvey | Physician Assistant | 708 E Wythe Creek Ct Ste 103, Kuna, ID 83634-5005 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1558896506 | Nicholas Tock | Social Worker | 190 W Main Street, Kuna, ID 83634 | 2017-04-27 |
| 1790137073 | Jeremy Walker | Dentist | 1353 N Meridian Rd, Ste 101, Kuna, ID 83634 | 2016-07-11 |
| 1194171678 | Kidspeak LLC | Occupational Therapist | 525b Main St, Kuna, ID 83634 | 2016-05-13 |
| 1447617139 | Matt Jordan | Nurse Practitioner | 13900 South Pleasant Valley Road, Kuna, ID 83634 | 2016-01-26 |
| 1386063980 | Colin Brown | Physician Assistant | 13500 S. Pleasant Valley, Kuna, ID 83634 | 2014-04-10 |
| 1912329806 | Brady Tucker | Pharmacist | 1403 North Meridian Rd, Kuna, ID 83634 | 2014-01-10 |
| 1427489954 | Ridley's Family Markets, Inc | Pharmacy | 1403 N Meridian Rd, Kuna, ID 83634 | 2013-12-10 |
| 1538414354 | William Lincoln Poulson | Nurse Practitioner | 13500 South Pleasant Valley Road, Kuna, ID 83634 | 2012-07-18 |
| 1508036286 | Michelle Marie Montoya | Counselor | 190 W. Main St, Kuna, ID 83634 | 2008-03-10 |
| Find all providers in zip 83634 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033752498 | Selah Worley | Nurse Practitioner | 13500 Pleasant Vly Rd, Kuna, ID 83634-2709 | 2019-10-17 |
| 1447617139 | Matt Jordan | Nurse Practitioner | 13900 South Pleasant Valley Road, Kuna, ID 83634 | 2016-01-26 |
| 1538414354 | William Lincoln Poulson | Nurse Practitioner | 13500 South Pleasant Valley Road, Kuna, ID 83634 | 2012-07-18 |
| 1952617896 | Clayleen Jo Harrington | Nurse Practitioner | 1619 N Linder Rd Ste 104, Kuna, ID 83634-3010 | 2010-08-30 |
| 1649813577 | Crystalyn Lou Bryan | Nurse Practitioner | 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 | 2019-10-23 |
| 1124660931 | Anthony Bruce Reece | Nurse Practitioner | 14601 S Pleasant Valley Rd, Kuna, ID 83634-2728 | 2019-10-14 |
| 1518492479 | Stephen Douglas Martin | Nurse Practitioner | 13400 S Pleasant Valley Rd, Kuna, ID 83634-2716 | 2017-04-27 |
| 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 |
| 1730787482 | John Dustin Pena | Nurse Practitioner | 102 Courthouse Dr Ste F, Salmon, ID 83467-3905 | 2020-10-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KUNA FAMILY MEDICAL CLINIC, P. A..
| 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.