JERILYN R BODEY (NPI# 1932670866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932670866 |
| Entity Type | Individual |
| Full Name | JERILYN R BODEY |
| Credential | FNP-C |
| Practice Address |
415 6th St Lewiston ID 83501 |
| Mailing Address |
7500 Rialto Blvd Ste 1-140 Austin TX 78735-8534 |
| Practice Telephone | 5127303056 |
| Practice Fax Number | 8887301925 |
| Mailing Telephone | 5127303056 |
| Mailing Fax Number | 8887301925 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2019-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
60187 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 538 E Clark St, Paul, ID 833475503 | 2086705529 |
| Street Address |
415 6TH ST |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501 |
| 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 |
| 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 |
| 1649762964 | Alexis C Luper | Social Worker | 415 6th St, Lewiston, ID 83501-2434 | 2018-06-01 |
| 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 | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831746239 | Amanda Adams | Nurse Practitioner | 5226 Walmore Rd, Lewiston, NY 14092-9733 | 2019-08-20 |
| 1891258182 | Tamara Dawn Demean | Nurse Practitioner | 1331 G St, Lewiston, ID 83501-1964 | 2019-04-12 |
| 1518436450 | Sokharath Keller | Nurse Practitioner | 12 High St Ste 302, Lewiston, ME 04240-7690 | 2018-11-21 |
| 1982170403 | Sara Denoncourt | Nurse Practitioner | 99 Campus Ave Ste 301, Lewiston, ME 04240-6045 | 2018-10-23 |
| 1659877637 | Donna Poirier | Nurse Practitioner | 733 Center St, Lewiston, NY 14092-1705 | 2018-03-30 |
| 1972013852 | Katelyn Marie Rock | Nurse Practitioner | 10 High St Ste 305, Lewiston, ME 04240-7656 | 2017-10-05 |
| 1518327576 | Lauren Blais | Nurse Practitioner | 77 Bates St Ste 201, Lewiston, ME 04240-7637 | 2016-03-03 |
| 1073983748 | Tracy Streibick Flynn | Nurse Practitioner | 500 8th Ave Rm 205, Lewiston, ID 83501-2691 | 2015-10-06 |
| 1679963284 | Amy Lynette Larson | Nurse Practitioner | 338 6th St # 101, Lewiston, ID 83501-2420 | 2015-02-03 |
| 1679989222 | Stephanie Mellen | Nurse Practitioner | 330 Sabattus St Ste B, Lewiston, ME 04240-5553 | 2014-07-03 |
| Find all providers in LEWISTON | ||||
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| 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.