Travis Lee Taylor, FNP-C, CRNFA | |
30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | |
(208) 265-9817 | |
Not Available |
Full Name | Travis Lee Taylor |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 11 Years |
Location | 30544 Highway 200 Ste 102, Ponderay, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255597811 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163WR0006X | Registered Nurse - Registered Nurse First Assistant | N-37973 (Idaho) | Secondary |
363LF0000X | Nurse Practitioner - Family | NP-1376A (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Bonner General Hospital | Sandpoint, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Michael R Dibenedetto Md Pllc | 0840385670 | 7 |
Entity Name | Boundary Community Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801896683 PECOS PAC ID: 3274583406 Enrollment ID: O20050126000312 |
Entity Name | Michael R Dibenedetto Md Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083809727 PECOS PAC ID: 0840385670 Enrollment ID: O20071009000187 |
Mailing Address | Practice Location Address |
---|---|
Travis Lee Taylor, FNP-C, CRNFA 335 S Lavina Ave, Sandpoint, ID 83864-1721 Ph: (208) 946-8219 | Travis Lee Taylor, FNP-C, CRNFA 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 Ph: (208) 265-9817 |
Katrina Ann Cavanaugh, APRN-CNP, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 188 Birch Ave, Ponderay, ID 83852 Phone: 208-597-2508 | |
Justin Henderson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 30544 Id-200, #101, Ponderay, ID 83852 Phone: 208-263-6300 | |
Kathy Gavin, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 30410 Highway 200, Ponderay, ID 83852 Phone: 208-263-1345 Fax: 208-255-5531 | |
Graham Charles Andrews, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 400 Schweitzer Plaza Dr Ste 1, Ponderay, ID 83852 Phone: 208-263-0649 |