| Mrs Amanda Jo Prestigiacomo, FNP-C | |
|
350 N Haven Dr, Twin Falls, ID 83301-5788 | |
| (208) 904-4780 | |
| (208) 904-4832 |
| Full Name | Mrs Amanda Jo Prestigiacomo |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 9 Years |
| Location | 350 N Haven Dr, Twin Falls, 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 |
|---|---|---|---|
| 1043747579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 55632 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Magic Valley Rmc | Twin falls, ID | Hospital |
| St Luke's Wood River Medical Center | Ketchum, ID | Hospital |
| St Luke's Jerome | Jerome, ID | Hospital |
| Minidoka Memorial Hospital | Rupert, ID | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic Llc | 1052217478 | 313 |
| Entity Name | St Lukes Clinic LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Entity Name | Idaho Kidney Institute LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013064690 PECOS PAC ID: 9032155312 Enrollment ID: O20050708000247 |
| Entity Name | Visions Home Health & Visions Home Care LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235137761 PECOS PAC ID: 0648174268 Enrollment ID: O20200319002235 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Amanda Jo Prestigiacomo, FNP-C Po Box 268934, Oklahoma City, OK 73126-8934 Ph: (208) 904-4780 | Mrs Amanda Jo Prestigiacomo, FNP-C 350 N Haven Dr, Twin Falls, ID 83301-5788 Ph: (208) 904-4780 |
Madison Christine Campbell, MSN, APRN, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments 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: 1329 Park View Dr, Twin Falls, ID 83301 Phone: 208-738-7200 Fax: 208-277-3488 |
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 |
Jonathan Kurz, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2167 Village Park Ave Ste 300, Twin Falls, ID 83301 Phone: 208-733-5117 |
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: Accepting Medicare Assignments Practice Location: 2550 Addison Ave E Ste E, Twin Falls, ID 83301 Phone: 208-814-7780 Fax: 208-814-7746 |