SIS E OSTOLASA (NPI# 1013952761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013952761 |
| Entity Type | Individual |
| Full Name | SIS E OSTOLASA |
| Credential | PA |
| Practice Address |
3025 W Cherry Lane Ste B Meridian ID 83642 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642 |
| Practice Telephone | 2083026450 |
| Practice Fax Number | 2083026455 |
| Mailing Telephone | 2083026450 |
| Mailing Fax Number | 2083026455 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2016-11-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA386 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806249800 | 05 |
| Street Address |
3025 W CHERRY LANE STE B |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124092101 | Albert Donald Bickford | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642-1026 | 2006-02-15 |
| 1639680051 | Chad Dennis Talford | Physician Assistant | 3025 W Cherry Lane, Meridian, ID 83642 | 2017-10-12 |
| 1326590498 | Katrina Merrell | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2016-10-25 |
| 1710438874 | Carin Bohan | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2016-10-24 |
| 1366993883 | Nathan James Richard | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2016-10-19 |
| 1629446661 | Lori Katherine Ebinger | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2015-09-08 |
| 1033504147 | Aaron Dunham | Psychiatry & Neurology | 3025 W Cherry Lane, Ste 204, Meridian, ID 83642 | 2015-04-06 |
| 1508142613 | Kristina Huffaker | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2011-11-02 |
| 1629201249 | Cory M Martin | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2009-08-30 |
| 1659504314 | Mark B Cheney | Family Medicine | 3025 W Cherry Lane, Meridian, ID 83642 | 2009-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134401326 | A Teresa Gabiola Shelton | Physician Assistant | 3025 E Cherry Lane, Ste B, Meridian, ID 83642-8531 | 2011-09-13 |
| 1386933513 | Laura Poly | Physician Assistant | 2971 E Copper Point Dr Ste 125, Meridian, ID 83642-9277 | 2011-03-28 |
| 1548265218 | Rick Steinburg | Physician Assistant | 3085 E Magic View Dr # 140, Meridian, ID 83642-3757 | 2005-06-17 |
| 1992337034 | Whitney Sloan Bancroft Trammell | Physician Assistant | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2020-02-06 |
| 1851957005 | Samantha Christine Verner | Physician Assistant | 260 S Ten Mile Rd, Meridian, ID 83642-6100 | 2019-05-14 |
| 1710438874 | Carin Bohan | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2016-10-24 |
| 1366993883 | Nathan James Richard | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2016-10-19 |
| 1013466200 | Benjamin Watson | Physician Assistant | 520 S Eagle Rd, Suite 1234, Meridian, ID 83642-6351 | 2016-09-28 |
| 1982944617 | Tate J Hansen | Physician Assistant | 520 S Eagle Rd, Ste 1222, Meridian, ID 83642-6351 | 2013-02-16 |
| 1508142613 | Kristina Huffaker | Physician Assistant | 3025 W Cherry Lane, Ste B, Meridian, ID 83642 | 2011-11-02 |
| Find all providers in MERIDIAN | ||||
Please comment or provide details below to improve the information on SIS E OSTOLASA.
| 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.