Emily Renee Wittenberg, | |
2609 S 10th Ave Ste 102, Caldwell, ID 83605-6885 | |
(208) 454-2766 | |
Not Available |
Full Name | Emily Renee Wittenberg |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 2609 S 10th Ave Ste 102, Caldwell, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720797657 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 65681 (Idaho) | Primary |
Entity Name | Lifeways Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568558955 PECOS PAC ID: 4183696214 Enrollment ID: O20140410000839 |
Mailing Address | Practice Location Address |
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Emily Renee Wittenberg, 702 Sunset Dr, Ontario, OR 97914-3121 Ph: (541) 889-9167 | Emily Renee Wittenberg, 2609 S 10th Ave Ste 102, Caldwell, ID 83605-6885 Ph: (208) 454-2766 |
Cynthia Jane Floyd, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15076 Plum Rd, Caldwell, ID 83607 Phone: 208-830-5560 | |
Matthew Fowler, AGNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605 Phone: 208-649-4315 Fax: 208-649-4513 | |
Ashley Fae White, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-459-4641 | |
Mrs. Deborah Lee Sullivan, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 211 E Logan St, Suite 105, Caldwell, ID 83605 Phone: 208-454-0567 Fax: 208-402-6635 | |
Lynette Joy Ages, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 S 10th Ave Ste 200, Caldwell, ID 83605 Phone: 208-453-6417 Fax: 208-453-6419 | |
Robert Slade Thacker, APRN CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave, Ste. 230, Caldwell, ID 83605 Phone: 208-459-4667 | |
Crystal Gail Belcourt, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1620 S Kimball Ave, Caldwell, ID 83605 Phone: 208-505-2950 Fax: 208-505-2955 |