Mr Brian P Vandendries, NP | |
520 S Eagle Rd, Suite 2213, Meridian, ID 83642-6351 | |
(208) 706-5447 | |
(208) 706-5448 |
Full Name | Mr Brian P Vandendries |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Occupational Health |
Location | 520 S Eagle Rd, Meridian, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255485561 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LX0106X | Nurse Practitioner - Occupational Health | NP-637 (Idaho) | Primary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
---|---|
Mr Brian P Vandendries, NP 190 E Bannock St, Boise, ID 83712-6241 Ph: (208) 706-7500 | Mr Brian P Vandendries, NP 520 S Eagle Rd, Suite 2213, Meridian, ID 83642-6351 Ph: (208) 706-5447 |
Jennifer Lytle, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3280 E Lanark Dr, Meridian, ID 83642 Phone: 208-895-8670 Fax: 208-955-0494 | |
Rachael Marie Knuteson, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1948 S Eagle Rd, Meridian, ID 83642 Phone: 208-322-7900 | |
Heidi Ann Fanslow, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6830 N Agrarian Ave, Meridian, ID 83646 Phone: 253-951-8331 | |
Josef Mcguire, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3080 E Gentry Way Ste 210, Meridian, ID 83642 Phone: 208-384-9022 | |
Melanie Maltese, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14 S Baltic Pl, Meridian, ID 83642 Phone: 208-887-4872 | |
Michael Pahang, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1550 N Crestmont Dr, Meridian, ID 83642 Phone: 208-288-4200 Fax: 208-288-4279 | |
Sarah Cheree Johnson, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3653 N Locust Grove Rd, Meridian, ID 83646 Phone: 208-302-7300 Fax: 208-302-7355 |