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:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548253867 | NPPES |
| Idaho | MEDICAID | 1548253867 |
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