| Preventative Health | |
|
531 S Fitness Pl Ste 100 Eagle ID 83616-6552 | |
| (208) 853-2273 | |
| Not Available |
| Full Name | Preventative Health |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 531 S Fitness Pl Ste 100, Eagle, Idaho |
| Authorized Official Name and Position | Danielle Bennion (OWNER) |
| Authorized Official Contact | 2088532273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preventative Health 531 S Fitness Pl 100 Eagle ID 83616-6552 Ph: (208) 853-2273 | Preventative Health 531 S Fitness Pl Ste 100 Eagle ID 83616-6552 Ph: (208) 853-2273 |
| NPI Number | 1922377027 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 04/10/2017 |
| Medicare PECOS PAC ID | 2264696368 |
|---|---|
| Medicare Enrollment ID | O20120620000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922377027 | NPI | - | NPPES |
| Provider Name | Cynda Le Tomlinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891703070 PECOS PAC ID: 9638119969 Enrollment ID: I20080619000546 |
| Provider Name | Stacy Shelton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992030928 PECOS PAC ID: 3870632235 Enrollment ID: I20091125000271 |
| Provider Name | Shannon Binder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710386396 PECOS PAC ID: 4688895527 Enrollment ID: I20141017002390 |
| Provider Name | Christine A Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891176798 PECOS PAC ID: 1850606369 Enrollment ID: I20150812009000 |
| Provider Name | Stacie M Mccomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366982621 PECOS PAC ID: 0446528806 Enrollment ID: I20170608000947 |
| Provider Name | Vicki Goss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770126062 PECOS PAC ID: 8123493251 Enrollment ID: I20231012003462 |
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