Individual
HOLLY BETH PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1919 LINCOLN WAY STE 415, COEUR D ALENE, ID 83814-2527
(208) 625-4595
(208) 625-4596
Mailing address
1919 LINCOLN WAY STE 415, COEUR D ALENE, ID 83814-2527
(208) 625-4595
(208) 625-4596
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30007003
WA
363L00000X
Nurse Practitioner
Primary
NP-690A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548253867
—
ID
Enumeration date
08/23/2005
Last updated
05/15/2024
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