| Sara Wilson, | |
|
1074 W Main St, Middleton, ID 83644-5270 | |
| (208) 989-9909 | |
| (208) 266-9234 |
| Full Name | Sara Wilson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 1074 W Main St, Middleton, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417338104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | NP-1568A (Idaho) | Primary |
| Entity Name | Mountain West Spine LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982462008 PECOS PAC ID: 7214475797 Enrollment ID: O20240815000192 |
| Mailing Address | Practice Location Address |
|---|---|
| Sara Wilson, 1074 W Main St, Middleton, ID 83644-5270 Ph: (208) 989-9909 | Sara Wilson, 1074 W Main St, Middleton, ID 83644-5270 Ph: (208) 989-9909 |
Suzanne Elise Monaghan, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 381 S Middleton Rd Ste B, Middleton, ID 83644 Phone: 208-585-6311 |
Beverlee K Furner, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 201 S 1st Ave E, Middleton, ID 83644 Phone: 208-585-0048 Fax: 208-585-6242 |
Rebecca Ann Swainston, MS FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 381 S Middleton Rd Ste B, Middleton, ID 83644 Phone: 208-585-6311 Fax: 208-585-6221 |
Mrs. Erin Keller, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 201 S. 1st Ave. E, Middleton, ID 83644 Phone: 208-585-6311 Fax: 208-585-6221 |
Samuel Hally, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1346 Cimarron Ct, Middleton, ID 83644 Phone: 208-695-8001 |