| Ms Johanna Christine Matthews, PMHNP-BC | |
|
827 W Prairie Ave, Hayden, ID 83835-8459 | |
| (208) 719-7158 | |
| (208) 500-2508 |
| Full Name | Ms Johanna Christine Matthews |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 827 W Prairie Ave, Hayden, 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 |
|---|---|---|---|
| 1851058549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | AP61375125 (Washington) | Secondary |
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | 70647 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Serene Integrative Services Llc | 5395285365 | 4 |
| Entity Name | Serene Integrative Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366122806 PECOS PAC ID: 5395285365 Enrollment ID: O20240905003273 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Johanna Christine Matthews, PMHNP-BC 165 E Hawthorne Ave, Colville, WA 99114-2629 Ph: (509) 684-4597 | Ms Johanna Christine Matthews, PMHNP-BC 827 W Prairie Ave, Hayden, ID 83835-8459 Ph: (208) 719-7158 |
Brian Carroll, Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 8552 N Government Way, Hayden, ID 83835 Phone: 208-772-7600 | |
Mrs. Amy Ann Wiebusch, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 43 W Prairie Shopping Ctr, Hayden, ID 83835 Phone: 208-772-2774 | |
Katrina Ann Susca, RN, IBCLC Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1076 W Hayden Ave, Hayden, ID 83835 Phone: 208-772-2823 | |
Susan Johnson, RNFA Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 827 W Prairie Ave, Hayden, ID 83835 Phone: 086-609-3782 Fax: 208-946-4172 | |
Mrs. Valerie Joann Rounds, FNP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 8512 N Wayne Dr, Hayden, ID 83835 Phone: 208-361-2146 Fax: 208-415-4805 | |
Miss Gayle L Freeman, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 43 W Prairie Shopping Ctr, Hayden, ID 83835 Phone: 208-772-2774 |