Pena, Holly Beth

Pena, Holly Beth is an individual health care provider with primary practice located at 1919 Lincoln Way Ste 415 , Coeur D Alene ID 83814-2527. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Pena, Holly Beth can be contacted via phone (208) 625-4595.

Contact Information

Primary practice address
1919 Lincoln Way Ste 415 Coeur D Alene ID 83814-2527
Phone: (208) 625-4595
Fax: (208) 625-4596
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30007003 Washington
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP-690A Idaho

Profile Details

NPI number 1548253867
LBN Legal business name Pena, Holly Beth
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated May 15th, 2024 - about 7 months 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 1548253867 NPPES
Idaho MEDICAID 1548253867

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