Nicole Manning (NPI# 1265441547, PAC ID# 1052334166) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1265441547 |
| PAC ID by PECOS | 1052334166 |
| Professional Enrollment ID | I20060104000360 |
| Full Name | Nicole Manning |
| Organization Legal Name | MVH PIC LLC |
| Address |
495 Yellowstone Ave Pocatello ID 83201-4531 |
| Phone Number | 2084787422 |
| Gender | F |
| Credential | PA |
| Graduation Year | 2000 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 6709156904 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130065 | MOUNTAIN VIEW HOSPITAL |
| 130028 | PORTNEUF MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 134 W Chubbuck Rd, Suite B, Chubbuck, ID 83202-2383 | 2082377911 | MVH PIC LLC |
| 475 Yellowstone Ave, Suite E, Pocatello, ID 83201-4528 | 2082320021 | MVH PMHS LLC |
| 495 Yellowstone Ave, Pocatello, ID 83201-4531 | 2084787422 | MVH PIC LLC |
| Organization Legal Name | MVH PIC LLC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lana J Borgholthaus | Physician Assistant | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Titus Kener | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Randy P Vawdrey | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Adam A Packer | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Danielle F Hamill | Physician Assistant | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Trilby M Wedler | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Michelle Clegg | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| David J Mcgregor | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Nicholas A Hale | Physician Assistant | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Wesley Ward | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Street Address |
495 YELLOWSTONE AVE |
| City | POCATELLO |
| State | ID |
| Zip | 83201-4531 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lana J Borgholthaus | Physician Assistant | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Titus Kener | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Randy P Vawdrey | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Adam A Packer | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Danielle F Hamill | Physician Assistant | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Trilby M Wedler | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Michelle Clegg | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| David J Mcgregor | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Nicholas A Hale | Physician Assistant | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Wesley Ward | Nurse Practitioner | Mvh Pic LLC | 495 Yellowstone Ave, Pocatello, ID 83201-4531 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy A Flicker | Physical Therapy | 2839 Margo Ln, Pocatello, ID 83201-1961 | |
| Michael D Lance | Psychiatry | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Kenneth A Cogen | Nephrology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Randall J Skeem | Internal Medicine | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Martha Elizabeth Franz | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| John L Shuss | General Surgery | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Ciara C Christensen | Clinical Psychologist | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Robin L Hall | Nurse Practitioner | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Laurence L Martens | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Terry J Buccambuso | Diagnostic Radiology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Find all physicians in zip 83201 | |||
| City | POCATELLO |
| Zip Code | 83201 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | POCATELLO + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Nicole Manning.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.