KYLE HOLLENBACK (NPI# 1932574381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932574381 |
| Entity Type | Individual |
| Full Name | KYLE HOLLENBACK |
| Practice Address |
2280 American Legion Blvd Mountain Home ID 83647-3142 |
| Mailing Address |
486 W 1st Ave Glenns Ferry ID 83623-2701 |
| Practice Telephone | 2085873988 |
| Practice Fax Number | 2085873324 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2020-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1330 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 486 W 1st Ave, Glenns Ferry, ID 836232701 | 2083667416 |
| Street Address |
2280 AMERICAN LEGION BLVD |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647-3142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972534741 | Daniel Wood | Dentist | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2006-07-06 |
| 1104477512 | Frank Monasterio | Counselor | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2019-09-26 |
| 1306497060 | Austen Davis Kemper | Dietitian, Registered | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2019-09-24 |
| 1699328591 | Connie S Powers | Counselor | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2019-07-19 |
| 1750949848 | Steven Trayce Elliott | Dentist | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2019-06-03 |
| 1396289153 | Chad Robert Steele | Dental Hygienist | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2016-12-14 |
| 1083065171 | Kylee Jasper | Social Worker | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2016-06-29 |
| 1427407824 | Katherine Gray | Family Medicine | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2016-06-07 |
| 1982089678 | Glenns Ferry Health Center | Dentist | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2015-07-23 |
| 1124400890 | Tyler Mark Whiting | Dentist | 2280 American Legion Blvd, Mountain Home, ID 83647-3142 | 2015-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| Find all providers in zip 83647 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871092189 | Joseph Wells Hoskin | Physician Assistant | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2018-02-02 |
| 1144607268 | Hillary-paige Graves Potter | Physician Assistant | 17 Medical Plz, Mountain Home, AR 72653-2918 | 2015-04-27 |
| 1891197570 | Emily Moore | Physician Assistant | 465 Mckenna Dr, Mountain Home, ID 83647-2143 | 2014-09-24 |
| 1952738577 | Jonathan Grant Casto | Physician Assistant | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2013-09-27 |
| 1922435544 | Ashley Genee Casto | Physician Assistant | 2280 American Legion Blvd, Mountain Home, ID 83647 | 2013-09-27 |
| 1982791927 | John Frank Testerman IIi | Physician Assistant | James H. Quillen/vamc, Corner of Sidney and Lamont (johnson City), Mountain Home, TN 37686 | 2006-10-10 |
| 1609807247 | Karen Miller Gunn | Physician Assistant | Lamont Street, Mountain Home, TN 37684 | 2006-07-05 |
| 1194765875 | Nancy Karen Bell | Physician Assistant | James H. Quillen Vamc, Dogwood Ave. 111c, Mountain Home, TN 37684 | 2006-06-08 |
| 1447215066 | James C Roelke | Physician Assistant | 628 Hospital Dr, Ground Floor, Suite A, Mountain Home, AR 72653-2953 | 2006-04-18 |
| 1336110980 | Delmar Wallace Smith | Physician Assistant | 2000 American Legion Blvd, Mountain Home, ID 83647-3138 | 2006-01-31 |
| Find all providers in MOUNTAIN HOME | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
Please comment or provide details below to improve the information on KYLE HOLLENBACK.
| 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.