Ms Kathleen Annette Puderbaugh, ARNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Everson, Washington. Her current practice location is
6760 Mission Rd, Everson, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 966-2106.
Ms Kathleen Annette Puderbaugh is licensed to practice in Washington (license number AP30003425) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366433864.
Provider's Profile
| Full Name | Ms Kathleen Annette Puderbaugh |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Women's Health |
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| Location | 6760 Mission Rd, Everson, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1366433864
- Provider Enumeration Date: 11/02/2005
- Last Update Date: 12/21/2011
Medicare PECOS Information:
- PECOS PAC ID: 0446412175
- Enrollment ID: I20120425000700
Medical Identifiers
Medical identifiers for Ms Kathleen Annette Puderbaugh such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1366433864 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2200X | Nurse Practitioner - Adult Health | AP30003425 (Washington) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | AP30003425 (Washington) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Kathleen Annette Puderbaugh allows following entities to bill medicare on her behalf.
| Entity Name | Nooksack Central Management System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568528842
PECOS PAC ID: 3971651530
Enrollment ID: O20090508000338 |
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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. Ms Kathleen Annette Puderbaugh is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Kathleen Annette Puderbaugh, ARNP
6432 Olson Rd,
Ferndale, WA 98248-8514
Ph: (360) 383-0693 | Ms Kathleen Annette Puderbaugh, ARNP
6760 Mission Rd,
Everson, WA 98247-9749
Ph: (360) 966-2106 |
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