| Krystal King, | |
| 
					1411 Fillmore St Ste 600, Twin Falls, ID 83301-3343  | |
| (208) 933-4400 | |
| Not Available | 
| Full Name | Krystal King | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 1411 Fillmore St Ste 600, Twin Falls, Idaho | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1912383498 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | NP-1613A (Idaho) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | 5530782-4405 (Utah) | Primary | 
| Entity Name | Utah Surgical Associates Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1851450720 PECOS PAC ID: 4486686698 Enrollment ID: O20050908000912  | 
| Entity Name | Home Clinix Utah Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1891455895 PECOS PAC ID: 7810376977 Enrollment ID: O20220620001418  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Krystal King, 11 N Balsam Way, Price, UT 84501-4173 Ph: () -  | Krystal King, 1411 Fillmore St Ste 600, Twin Falls, ID 83301-3343 Ph: (208) 933-4400  | 
Madison Christine Campbell, MSN, APRN, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 815 N College Rd, Twin Falls, ID 83301 Phone: 208-814-9100 Fax: 208-814-9903  | |
Janice Carter, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2086 Addison Ave E, Twin Falls, ID 83301 Phone: 208-733-9697 Fax: 208-733-3197  | |
Amy Lou Jensen, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1880 Fillmore St, Twin Falls, ID 83301 Phone: 208-735-8386 Fax: 208-735-0434  | |
Lesley D. Goulding, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301 Phone: 208-814-8740 Fax: 208-814-8955  | |
Mrs. Amanda Jo Prestigiacomo, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 350 N Haven Dr, Twin Falls, ID 83301 Phone: 208-904-4780 Fax: 208-904-4832  | |
Mrs. Raemi Dawn Nolevanko, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000  | |
Reatta Omoth, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2550 Addison Ave E Ste E, Twin Falls, ID 83301 Phone: 208-814-7780 Fax: 208-814-7746  |