LUISA BRODEN (NPI# 1003434283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003434283 |
Entity Type | Individual |
Full Name | LUISA BRODEN |
Practice Address |
902 N Almon St Apt 3 Moscow ID 83843-8544 |
Mailing Address |
615 E 9th Ave Colville WA 99114-9463 |
Practice Telephone | 5096753813 |
Mailing Telephone | 5096753813 |
Enumeration Date | 2020-07-14 |
Last Update Date | 2020-07-14 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | ID | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | REGENCE | UDWW750166632 | 01 |
Street Address |
902 N ALMON ST APT 3 |
City | MOSCOW |
State | ID |
Zip Code | 83843-8544 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
Find all providers in zip 83843 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
1033633532 | Songah Chae | Student in an Organized Health Care Education/Training Program | 875 Perimeter Drive, Ms 3080, Moscow, ID 83844-3080 | 2017-07-27 |
1578096780 | Ashmel Vargas | Student in an Organized Health Care Education/Training Program | 709 S Deakin St, Moscow, ID 83844-9802 | 2017-04-05 |
1780116210 | Shelbie Jean Hackett | Student in an Organized Health Care Education/Training Program | 411 S Almon St # 1, Moscow, ID 83843-2219 | 2017-04-03 |
1487207072 | Mitchell Allen Collar | Student in an Organized Health Care Education/Training Program | 875 Perimeter Dr, Moscow, ID 83844-9803 | 2019-07-22 |
1962868117 | Ray Lee | Student in an Organized Health Care Education/Training Program | 2470 W Pullman Rd, Moscow, ID 83843-4034 | 2016-01-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134733694 | Susan L Boone | Student in an Organized Health Care Education/Training Program | 8506 W Donnybrook Dr, Boise, ID 83709-0606 | 2020-09-02 |
1255959003 | Daniel Isaiah Zebedeo | Student in an Organized Health Care Education/Training Program | 430 E Tiger Ave, Post Falls, ID 83854-6649 | 2020-07-08 |
1982229944 | Clayton Kline | Student in an Organized Health Care Education/Training Program | 881 E 3900 N, Buhl, ID 83316-5929 | 2020-06-15 |
1013538883 | Corbin Curtis Wood | Student in an Organized Health Care Education/Training Program | 355 W 4650 N, Rexburg, ID 83440-3206 | 2020-05-02 |
1407476120 | Remington Sloan Farley | Student in an Organized Health Care Education/Training Program | 4015 E Florence Dr Apt 101, Meridian, ID 83642-6185 | 2020-04-22 |
1184253585 | Tate Coltan Staker | Student in an Organized Health Care Education/Training Program | 1322 S 2nd E, Rexburg, ID 83440-3824 | 2020-04-07 |
1730715855 | Madison Hiatt | Student in an Organized Health Care Education/Training Program | 1209 W Targee St, Boise, ID 83706-4565 | 2020-03-20 |
1053946202 | Kaitlyn Casper | Student in an Organized Health Care Education/Training Program | 267 W Arrowrock Ln, Boise, ID 83706-4802 | 2020-03-09 |
1558996660 | Erik Malm | Student in an Organized Health Care Education/Training Program | 850 E Franklin Rd Ste 402, Meridian, ID 83642-8917 | 2020-03-09 |
1952955825 | Lani Jo Hernandez | Student in an Organized Health Care Education/Training Program | 6200 N River Pointe Dr Apt B203, Boise, ID 83714-1848 | 2019-07-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.