| Mrs Rachel Janette Kallemeyn, FNP | |
|
7173 E Super 1 Loop Ste B, Athol, ID 83801-7109 | |
| (208) 561-9901 | |
| (208) 561-9968 |
| Full Name | Mrs Rachel Janette Kallemeyn |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 7173 E Super 1 Loop Ste B, Athol, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235696287 | NPI | - | NPPES |
| 1235696287 | Medicaid | ID | |
| THP11576F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 95011208 (California) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 6361073 (Idaho) | Primary |
| Entity Name | Toiyabe Indian Health Project Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659433191 PECOS PAC ID: 2668419813 Enrollment ID: O20050411000182 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Rachel Janette Kallemeyn, FNP 1593 E Polston Ave, Post Falls, ID 83854-5326 Ph: (208) 262-2300 | Mrs Rachel Janette Kallemeyn, FNP 7173 E Super 1 Loop Ste B, Athol, ID 83801-7109 Ph: (208) 561-9901 |
Mrs. Holly Marie Heyne, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7173 E Super 1 Loop, Ste B, Athol, ID 83801 Phone: 208-561-9901 Fax: 208-561-9968 | |
Connie Marie Wilson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7173 E Super 1 Loop Ste B, Athol, ID 83801 Phone: 208-561-9901 Fax: 208-561-9968 |