ELISABETH GAYLE KINGHORN (NPI# 1871753061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871753061 |
Entity Type | Individual |
Full Name | ELISABETH GAYLE KINGHORN |
Credential | PA |
Practice Address |
651 Memorial Dr Pocatello ID 83201-4071 |
Practice Telephone | 2082392110 |
Practice Fax Number | 2082392136 |
Mailing Telephone | 2082392110 |
Mailing Fax Number | 2082392136 |
Enumeration Date | 2008-06-11 |
Last Update Date | 2008-06-11 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
PA-693 | ID | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | IDAHO LICENSE | PA-693 | 01 |
Street Address |
651 MEMORIAL DR |
City | POCATELLO |
State | ID |
Zip Code | 83201-4071 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871558239 | Michael L Francisco | Internal Medicine | 651 Memorial Dr, Portneuf Cancer Center, Pocatello, ID 83201 | 2006-04-19 |
1497051544 | Pocatello Health Services, LLC | Psychologist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2011-02-08 |
1124355813 | Phs Md #1, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
1760719454 | Phs Md #2, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
1689802852 | Pocatello Health Services, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-06-26 |
1760610935 | Pocatello Hospital, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-06-26 |
1295974368 | William E Hogan | Family Medicine | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-02-13 |
1083852727 | Pocatello Health Services, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-02-03 |
1932369568 | Ana Joy Weinhold | Family Medicine | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-17 |
1528228806 | Steven D Proctor | Social Worker | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
Find all providers in zip 83201 |
Taxonomy Code | 364SP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669408860 | Jane E Seys | Clinical Nurse Specialist | 13500 S. Pleasant Valley Rd, Idaho State Correctional Institution, Kuna, ID 83634 | 2006-06-23 |
1942201520 | Mary A Curtis | Clinical Nurse Specialist | 8100 W Emerald St, Suite 150, Boise, ID 83704-9055 | 2005-08-09 |
1952622524 | Affinity, Inc. | Clinical Nurse Specialist | 8100 W Emerald St Ste 150, Boise, ID 83704-9057 | 2010-06-18 |
1083880181 | Judith Eileen Sullivan | Clinical Nurse Specialist | 223 W State St, Boise, ID 83702-6013 | 2008-05-08 |
1619998713 | Connie J Judd | Clinical Nurse Specialist | 223 16th Ave N, Nampa, ID 83687-4058 | 2006-07-22 |
1316996309 | Deborah Gay Butte | Clinical Nurse Specialist | 300 S 23rd St, Boise, ID 83702-9100 | 2006-05-08 |
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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.