ELISABETH GAYLE KINGHORN


Address: 651 Memorial Dr, Pocatello, ID 83201-4071
Phone: 2082392110

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
ID IDAHO LICENSE PA-693 01

Office Location

Street Address 651 MEMORIAL DR
City POCATELLO
State ID
Zip Code 83201-4071

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 364SP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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

Competitor

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City POCATELLO
Zip Code 83201

Improve Information

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Dataset Information

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.

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