| Holly Beth Pena, ARNP | |
|
1919 Lincoln Way Ste 415, Coeur D Alene, ID 83814-2527 | |
| (208) 625-4595 | |
| (208) 625-4596 |
| Full Name | Holly Beth Pena |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 21 Years |
| Location | 1919 Lincoln Way Ste 415, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548253867 | NPI | - | NPPES |
| 1548253867 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | AP30007003 (Washington) | Secondary |
| 363L00000X | Nurse Practitioner | NP-690A (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Bonner General Hospital | Sandpoint, ID | Hospital |
| Benewah Community Hospital | St maries, ID | Hospital |
| Shoshone Medical Center | Kellogg, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kootenai Health Inc | 1355792276 | 382 |
| Entity Name | Prairie Family Medicine Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346444007 PECOS PAC ID: 5597851675 Enrollment ID: O20071020000077 |
| Entity Name | Kootenai Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252 |
| Mailing Address | Practice Location Address |
|---|---|
| Holly Beth Pena, ARNP 1919 Lincoln Way Ste 415, Coeur D Alene, ID 83814-2527 Ph: (208) 625-4595 | Holly Beth Pena, ARNP 1919 Lincoln Way Ste 415, Coeur D Alene, ID 83814-2527 Ph: (208) 625-4595 |
Deborah Magnuson, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1090 W Park Pl, Coeur D Alene, ID 83814 Phone: 208-215-2005 Fax: 844-807-3782 | |
Ms. Jayne S Shoda, MSN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1983 E Lookout Dr, Coeur D Alene, ID 83815 Phone: 208-964-0701 | |
Mary Sandra Duff, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 920 W Ironwood Dr, Coeur D Alene, ID 83814 Phone: 208-667-4557 Fax: 208-765-2887 | |
Sydney Elizabeth Disselkamp, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 378, Coeur D Alene, ID 83814 Phone: 208-625-3555 Fax: 208-769-8616 | |
Ms. Kristina Marie Follger, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814 Phone: 208-292-5437 Fax: 208-292-5441 | |
Jared Edward Bruder, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1110 W Park Pl Ste 320, Coeur D Alene, ID 83814 Phone: 208-261-2255 | |
Robin Marie Beard, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 120, Coeur D Alene, ID 83814 Phone: 208-625-3640 Fax: 208-625-3645 |