Nebeker, Kendall Logan

Nebeker, Kendall Logan is an individual health care provider with primary practice located at 4943 N 29Th E # B , Idaho Falls ID 83401-1314. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Nebeker, Kendall Logan can be contacted via phone (307) 257-5487.

Contact Information

Primary practice address
4943 N 29Th E # B Idaho Falls ID 83401-1314
Phone: (307) 257-5487
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1477297265
LBN Legal business name Nebeker, Kendall Logan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2022
Last updated Jan 4th, 2024 - about last year

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 1477297265 NPPES
Utah MEDICAID 1396085718

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