| Kevin Pendlebury, CDE | |
|
Mission Rd, Fort Hall, ID 83203-0306 | |
| (208) 238-2400 | |
| (208) 238-5462 |
| Full Name | Kevin Pendlebury |
|---|---|
| Gender | Male |
| Speciality | Registered Nurse - Diabetes Educator |
| Location | Mission Rd, Fort Hall, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528209129 | NPI | - | NPPES |
| 003399100 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | N31309 (Idaho) | Secondary |
| 163WD0400X | Registered Nurse - Diabetes Educator | 2061-0302 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Pendlebury, CDE Po Box 306, Fort Hall, ID 83203-0306 Ph: (208) 238-2400 | Kevin Pendlebury, CDE Mission Rd, Fort Hall, ID 83203-0306 Ph: (208) 238-2400 |
Garth S Brown, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Rd, Fort Hall, ID 83203 Phone: 208-238-2400 Fax: 208-238-5462 | |
Joanne Fletcher, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Rd, Fort Hall, ID 83203 Phone: 208-238-5435 Fax: 208-238-5462 | |
Richard Lee Mittelstedt, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Rd, Fort Hall, ID 83203 Phone: 208-238-5427 Fax: 208-238-5427 | |
Mrs. Deeanne M Marshall, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: Mission Rd, Fort Hall, ID 83203 Phone: 208-238-5427 | |
Ms. Stephanie Moss, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Rd, Fort Hall, ID 83203 Phone: 208-238-2400 Fax: 208-238-6292 | |
Mrs. Ashley L Ballensky, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 717 Mission Road, Fort Hall, ID 83203 Phone: 208-238-5423 Fax: 208-238-5465 |