MARY MAVENCAMP (NPI# 1033734470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033734470 |
| Entity Type | Individual |
| Full Name | MARY MAVENCAMP |
| Credential | LPN |
| Practice Address |
260 2nd Ave E Twin Falls ID 83301-6242 |
| Practice Telephone | 2087320959 |
| Practice Fax Number | 2087327480 |
| Mailing Telephone | 2087320959 |
| Mailing Fax Number | 2087327480 |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 11835 | ID | Nursing Service Providers |
| Street Address |
260 2ND AVE E |
| City | TWIN FALLS |
| State | ID |
| Zip Code | 83301-6242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164461042 | Boise Vamc | Clinic/Center | 260 2nd Ave E, Suite 12, Twin Falls, ID 83301-6242 | 2006-06-06 |
| 1649888710 | Nestor Hapayan | Registered Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-07-15 |
| 1770108631 | Jana Kay Juker | Licensed Practical Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-06-16 |
| 1891310728 | Faye L Lewis | Licensed Practical Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-06-16 |
| 1457976540 | Arlena Blick | Registered Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-06-15 |
| 1255956686 | Karen J Jennings | Registered Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-06-11 |
| 1538540695 | Virginia Gambrel | Licensed Practical Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2015-06-15 |
| 1306191366 | Jason Lee Taylor | Nurse Practitioner | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2012-07-16 |
| 1063424943 | Alex J Tubbs | Social Worker | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2006-08-12 |
| 1033121520 | Larry Kirk Hazen | Social Worker | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2006-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023645918 | Matthew Anderson | Pharmacist | Dick's Pharmacy, 526 K Shoup Ave W, Twin Falls, ID 83301 | 2020-03-23 |
| 1780146316 | Frontier Pediatric Partners, Pllc | Pediatrics | 1502 Locust Street N #700, Twin Falls, ID 83301 | 2019-04-02 |
| 1972073377 | Wood River Acupuncture | Acupuncturist | 1625 Addison Ave East, Twin Falls, ID 83301 | 2018-11-28 |
| 1235629874 | Lonnie Paul | Counselor | 1092 Eastland Dr N Ste A, Twin Falls, ID 83301 | 2018-05-17 |
| 1679060966 | Christina Jirapha Thongdee | Social Worker | 625 Poleline Road West, Suite 2a, Twin Falls, ID 83301 | 2018-04-23 |
| 1437658499 | Tyrel Kevin Ward | Chiropractor | 2167 Village Park Ave., Suite 100, Twin Falls, ID 83301 | 2018-02-06 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1578005195 | Matthew Carter | Physical Therapist | 1053 Eastland Drive, Twin Falls, ID 83301 | 2016-11-14 |
| 1790227783 | Murvat Usmanova | Nurse Practitioner | 775 Pole Line Road W, Suite 203, Twin Falls, ID 83301 | 2016-11-08 |
| 1265894687 | Shawna Fultz | Social Worker | 1201 Fall Ave East Suite C, Twin Falls, ID 83301 | 2016-03-24 |
| Find all providers in zip 83301 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108631 | Jana Kay Juker | Licensed Practical Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-06-16 |
| 1891310728 | Faye L Lewis | Licensed Practical Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2020-06-16 |
| 1538540695 | Virginia Gambrel | Licensed Practical Nurse | 260 2nd Ave E, Twin Falls, ID 83301-6242 | 2015-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487267266 | Mary Laree Kenworthy | Licensed Practical Nurse | 500 W Fort St Bldg 88, Boise, ID 83702-4598 | 2020-08-31 |
| 1457974669 | Marcey Louise Waugh | Licensed Practical Nurse | 500 W Fort St Bldg 124, Boise, ID 83702-4501 | 2020-05-21 |
| 1740801364 | Xochitl Hodgson | Licensed Practical Nurse | 28 Creekside Ln, Hope, ID 83836-9641 | 2020-05-05 |
| 1841712049 | Caitlinn Kuuipo Tanaka | Licensed Practical Nurse | 4835 Trent St, Chubbuck, ID 83202-2955 | 2017-07-10 |
| 1992154538 | Carolyn Blasch | Licensed Practical Nurse | 3912 Sage Creek Dr, Boise, ID 83714-5502 | 2016-06-05 |
| 1841671716 | Victoria Hamrick | Licensed Practical Nurse | 64 N Elijah Dr, Nampa, ID 83651-2209 | 2015-06-16 |
| 1679951545 | Steven Miranda | Licensed Practical Nurse | 1471 Mountain View Ln Apt 4, Idaho Falls, ID 83402-1861 | 2015-05-12 |
| 1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
| 1952700478 | Tiana Hernandez | Licensed Practical Nurse | 86 S Rolling Green St, Nampa, ID 83687-8921 | 2014-08-20 |
| 1326464991 | Michael Deschene Jr. | Licensed Practical Nurse | 641 E Wild Lilac St, Kuna, ID 83634-2388 | 2014-03-06 |
| Find all providers with the same taxonomy | ||||
| City | TWIN FALLS |
| Zip Code | 83301 |
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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.