Fibelstad, Vincent

Fibelstad, Vincent is an individual health care provider with primary practice located at 415 6Th St , Lewiston ID 83501-2431. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Fibelstad, Vincent can be contacted via phone (208) 743-2511.

Contact Information

Primary practice address
415 6Th St Lewiston ID 83501-2431
Phone: (208) 743-2511
Fax: (208) 799-5554
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-02 Idaho

Profile Details

NPI number 1184762825
LBN Legal business name Fibelstad, Vincent
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184762825 NPPES
Idaho Other HBNA1 IDAHO BLUE CROSS
Idaho Other 10017690 IDAHO BLUE CROSS
Idaho MEDICAID 8118705 IDAHO BLUE CROSS
Idaho Other 10017689 IDAHO BLUE CROSS

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