Kathy Gavin, FNP is a
Nurse Practitioner based in Ponderay, Idaho. Kathy Gavin is licensed to practice in Idaho (license number NP-257A) and her current practice location is
30410 Highway 200, Ponderay, Idaho. She can be reached at her office (for appointments etc.) via phone at
(208) 263-1345.
NPI number for Kathy Gavin is 1770598559 and her current mailing address is 30410 Highway 200, Ponderay, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770598559.
Provider's Profile
| Full Name | Kathy Gavin |
|---|
| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 30410 Highway 200, Ponderay, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1770598559
- Provider Enumeration Date: 07/30/2006
- Last Update Date: 12/13/2007
Medical Identifiers
Medical identifiers for Kathy Gavin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770598559 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | NP-257A (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathy Gavin is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kathy Gavin, FNP
30410 Highway 200,
Ponderay, ID 83852-9601
Ph: (208) 263-1345 | Kathy Gavin, FNP
30410 Highway 200,
Ponderay, ID 83852-9601
Ph: (208) 263-1345 |
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