Weston Vern Frandsen
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Mountain Home, ID
NPI 1265066971 · NPPES record last updated Jun 3, 2022
Key facts
- NPI
- 1265066971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 90 Hope Drive, BLDG 6000
Mountain Home, ID 83647 - Phone
- (208) 828-7300
- NPI assigned
- Mar 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-5148 | ID | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-5148 | ID | |
| Student in an Organized Health Care Education/Training Program | 390200000X | UT | Yes |
Addresses
Primary practice location
90 Hope Drive, BLDG 6000
Mountain Home, ID 83647
Mailing address
90 Hope Dr BLDG 6000
Mountain Home Afb, ID 83648-1062
Phone (208) 828-7300
Other providers in Mountain Home, ID
- Cheryl Lynn Fesperman
- Stacy Lynn Flatt
- Paulette A Flores
- Thressa K. Fogleman
- Fran'S Affordable Rides
- Karen Anne Galvan
- Alejandra Garcia
- Anna Marie Garvin
- Darin K Gere
- Jeffrey Eugene Gibbons
All providers in Mountain Home, ID · Student in an Organized Health Care Education/Training Program in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.