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John Dustin Pena, FNP
Family Nurse Practitioner in Salmon, Idaho
NPI 1730787482

John Dustin Pena is a Family Nurse Practitioner based in Salmon, ID and is specialized in Family. John Dustin Pena practices in Salmon, ID and has the professional credentials of FNP. The NPI Number for John Dustin Pena is 1730787482 and holds a License No. 65855 (Idaho).

The current practice location address for John Dustin Pena is 102 Courthouse Dr Ste F, Salmon, ID and can be reached out via phone at 208-742-1110 and via fax at 208-742-1120.

Location: 102 Courthouse Dr Ste F, Salmon, ID, 83467-3850
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730787482
Provider Name
John Dustin Pena
Credential
FNP
Provider Entity Type
Individual
Gender
Male
Address
102 Courthouse Dr Ste F, Salmon, ID, 83467-3850
Phone Number
208-742-1110
Fax Number
208-742-1120
Provider Enumeration Date
10/14/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
102 Courthouse Dr Ste F
City
Salmon
State
Idaho
Zip
83467-3905
Phone Number
208-742-1110
Fax Number
208-742-1120
person
Provider Business Mailing Address Details
Address
102 Courthouse Dr Ste F
City
Salmon
State
Idaho
Zip
83467-3905
Phone Number
208-742-1110
Fax Number
208-742-1120
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
65855 (Idaho)
Definition
Definition to come...
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