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1525 Addison Ave E Ste A2 Twin Falls ID 83301-5300 | |
| (208) 739-9961 | |
| (208) 739-9962 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1525 Addison Ave E Ste A2, Twin Falls, Idaho |
| Authorized Official Name and Position | Lindsay Hubsmith (OWNER) |
| Authorized Official Contact | 2083583225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1525 Addison Ave E Ste A2 Twin Falls ID 83301-5300 Ph: (208) 739-9961 | 1525 Addison Ave E Ste A2 Twin Falls ID 83301-5300 Ph: (208) 739-9961 |
| NPI Number | 1487393393 |
|---|---|
| Provider Enumeration Date | 05/31/2022 |
| Last Update Date | 12/20/2024 |
| Medicare PECOS PAC ID | 2365823069 |
|---|---|
| Medicare Enrollment ID | O20220712003605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487393393 | NPI | - | NPPES |
| Provider Name | Jennifer A Seegmiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194132431 PECOS PAC ID: 7618197732 Enrollment ID: I20141013000345 |
| Provider Name | Bryan L Gourley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629500947 PECOS PAC ID: 8921346727 Enrollment ID: I20190625001960 |
| Provider Name | Kristy Handyside |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437715208 PECOS PAC ID: 5294066254 Enrollment ID: I20191007001714 |
| Provider Name | Elizabeth C Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720710395 PECOS PAC ID: 0042680886 Enrollment ID: I20230112000486 |
| Provider Name | Erica L Sommer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720794399 PECOS PAC ID: 5991143521 Enrollment ID: I20240402002563 |
| Provider Name | Amy Marie Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194556399 PECOS PAC ID: 9234679846 Enrollment ID: I20240910003211 |
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