JUDY A METELKO (NPI# 1932247665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932247665 |
| Entity Type | Individual |
| Full Name | JUDY A METELKO |
| Credential | CNS,ARNP |
| Practice Address |
415 6th St Lewiston ID 83501-2431 |
| Practice Telephone | 2087432511 |
| Practice Fax Number | 2087995554 |
| Mailing Telephone | 2087432511 |
| Mailing Fax Number | 2087995554 |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
CNS-1A | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE OF IDAHO | 10017766 | 01 |
| WA | 9627472 | 05 | |
| ID | IDAHO BLUE CROSS IND | HBUR5 | 01 |
| ID | BLUE CROSS OF IDAHO | 8C576 | 01 |
| ID | 805366200 | 05 |
| Street Address |
415 6TH ST |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-2431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164414595 | William Westel Rowe | Internal Medicine | 415 6th St, Lewiston, ID 83501-2434 | 2005-08-22 |
| 1558995316 | Hospitalist Medicine Physicians of Idaho- Nampa Pllc | Emergency Medicine | 415 6th St, Lewiston, ID 83501-2431 | 2020-03-02 |
| 1003465360 | Kyle James Daly | Nurse Anesthetist, Certified Registered | 415 6th St, Lewiston, ID 83501-2431 | 2019-09-10 |
| 1184273708 | Kevin Dombey | Physician Assistant | 415 6th St, Lewiston, ID 83501-2431 | 2019-09-06 |
| 1952962813 | Andrea Bowen | Social Worker | 415 6th St, Lewiston, ID 83501-2431 | 2019-06-21 |
| 1881167609 | Christie Kytonen | Licensed Practical Nurse | 415 6th St, Lewiston, ID 83501-2431 | 2019-01-03 |
| 1295206134 | Nicholas Tieu | Physician Assistant | 415 6th St, Lewiston, ID 83501-2434 | 2018-12-17 |
| 1932670866 | Jerilyn R Bodey | Nurse Practitioner | 415 6th St, Lewiston, ID 83501 | 2018-12-17 |
| 1154800522 | Joanne Vestal | Pharmacist | 415 6th St, Lewiston, ID 83501-2434 | 2018-08-07 |
| 1174017701 | Samantha Lynn Musser | Registered Nurse | 415 6th St, Lewiston, ID 83501-2431 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720157589 | Patricia E Buls | Clinical Nurse Specialist | 460 Main St, Lewiston, ME 04240 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225139900 | Diane L Johnson | Clinical Nurse Specialist | 500 W Fort St, Boise, ID 83702-4501 | 2006-09-26 |
| 1033210091 | Anne Flickinger | Clinical Nurse Specialist | 500 W Fort St, Boise, ID 83702-4501 | 2006-09-25 |
| 1063512127 | Sheila K Tucker | Clinical Nurse Specialist | 500 W Fort St, Boise, ID 83702-4501 | 2006-09-25 |
Please comment or provide details below to improve the information on JUDY A METELKO.
| 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.