Mr Mark Nienhuis, PA is a
Physician Assistant based in Cuba, New Mexico. Mr Mark Nienhuis is licensed to practice in Ohio (license number 50001806) and his current practice location is
#10 Pueblo Pintado School, Cuba, New Mexico. He can be reached at his office (for appointments etc.) via phone at
(505) 786-5291.
NPI number for Mr Mark Nienhuis is 1417987868 and his current mailing address is Po Box 358, Crownpoint, New Mexico. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417987868.
Provider's Profile
| Full Name | Mr Mark Nienhuis |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
|---|
| Location | #10 Pueblo Pintado School, Cuba, New Mexico |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417987868
- Provider Enumeration Date: 07/03/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Mark Nienhuis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417987868 | NPI | - | NPPES |
| 97702242 | Medicaid | NM | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 50001806 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Nienhuis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Mark Nienhuis, PA
Po Box 358,
Crownpoint, NM 87313-0358
Ph: (505) 786-5291 | Mr Mark Nienhuis, PA
#10 Pueblo Pintado School,
Cuba, NM 87013
Ph: (505) 786-5291 |
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