MADONNA LEE KIENLEN (NPI# 1982116794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982116794 |
| Entity Type | Individual |
| Full Name | MADONNA LEE KIENLEN |
| Credential | PEER SPECIALIST |
| Practice Address |
215 Ethete Road Ft. Washakie WY 82514 |
| Mailing Address |
215 Ethete Road Fort Washakie WY 82514 |
| Practice Telephone | 3073358374 |
| Practice Fax Number | 3073358299 |
| Mailing Telephone | 3073358374 |
| Mailing Fax Number | 3073358299 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 2017-004-MM | WY | Other Service Providers |
| Street Address |
215 ETHETE ROAD |
| City | FT. WASHAKIE |
| State | WY |
| Zip Code | 82514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527819 | Melissa Rose Pine | Registered Nurse | 29 Blackcole Road, Fort Washakie, WY 82514 | 2019-09-19 |
| 1649789025 | Rebecca Charlene Willis | Technician, Other | Fort Washakie Healt Center Lab Ihs 29 Black Coal Drive, Fort Washakie, WY 82514 | 2017-09-28 |
| 1033553185 | Pauline Elizabeth Powers-peprah | Family Medicine | 29 Black Cole, Fort Washakie, WY 82514 | 2013-04-19 |
| 1528319373 | Amanda L Schultz | Licensed Practical Nurse | 110 Sharpnose Road, Fort Washakie, WY 82514 | 2012-09-19 |
| 1770898140 | Kelly Lynne Pretty Weasel | Clinic/Center | 29 Blackcole Dr, Fort Washakie, WY 82514 | 2010-08-10 |
| 1285950170 | Debra Kay Waters | Technician, Pathology | Black Coal Rd. Bldg. 29, Ft. Washakie, WY 82514 | 2010-04-16 |
| 1881919751 | Shoshone & Arapaho Tribal Substance Abuse Court | Clinic/Center | 215 Ethete Rd, Fort Washakie, WY 82514 | 2010-04-02 |
| 1770814253 | Christopher G Nelson | Spec/Tech, Pathology | 29 Black Coal Rd, Ft. Washakie, WY 82514 | 2010-01-22 |
| 1922339449 | Nina Williams | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Ft Washakie, WY 82514 | 2010-01-22 |
| 1821329459 | Karen Fay Gibson | Clinical Medical Laboratory | 29 Blackcoal Dr., Laboratory, Fort Washakie, WY 82514 | 2010-01-21 |
| Find all providers in zip 82514 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841760410 | Christopher Michael Evans | Peer Specialist | 1221 W 5th Street, Sheridan, WY 82801 | 2018-11-27 |
| 1578031639 | Trina M Krepcik | Peer Specialist | 1406 S Boxelder St Apt 1, Casper, WY 82604-3374 | 2018-11-07 |
| 1316310105 | Emileigh Hillstead | Peer Specialist | 419 4th St, Evanston, WY 82930-3616 | 2015-11-03 |
| 1144836271 | Wood M Palmer | Peer Specialist | 610 W Broadway Ave Ste L1, Jackson, WY 83001-8213 | 2020-09-23 |
| 1265065973 | Jennifer Nicole Rossiter | Peer Specialist | 201 W Lakeway Rd Ste 1004, Gillette, WY 82718-6349 | 2020-02-20 |
| 1073155339 | Chellidy Simpson | Peer Specialist | 121 S 4th St, Thermopolis, WY 82443-2634 | 2019-10-08 |
| 1255998423 | Tanya A Tsukas | Peer Specialist | 1701 W 5th St Ste C, Sheridan, WY 82801-2749 | 2019-05-23 |
| 1386115285 | Adam Christensen | Peer Specialist | 389 Adams St, Afton, WY 83110 | 2018-12-17 |
| 1639649072 | Gwen A Andrews | Peer Specialist | 501 S Burma Ave, Gillette, WY 82716-3426 | 2018-11-28 |
| 1386110849 | Michaela Mary Tschirhart | Peer Specialist | 1110 Major Ave, Riverton, WY 82501-2342 | 2018-10-22 |
| Find all providers with the same taxonomy | ||||
| City | FT. WASHAKIE |
| Zip Code | 82514 |
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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.