Christine Fuhrman Mladenka, DNP, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

NP-338 Issued in ID

Practice address

1901 Alvin Ricken Dr
Pocatello, ID 83201-2727

Phone

(208) 233-9080

NPI assigned

Dec 28, 2006

Last updated

Apr 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tina Mladenka Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dna With Tina LLC

  • Women's Health Nurse Practitioner
  • Pocatello, ID
  • NPI 1306105598
  Authorized official Same address or phone
• Southeastern District Health Department

  dba Southeastern Idaho Public Health

  • Public Health or Welfare Agency
  • Pocatello, ID
  • NPI 1750526216
  NPD (past)
• State of Idaho

  dba Southeastern District Health Department

  • Public Health or Welfare Agency
  • Pocatello, ID
  • NPI 1063576445
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1740346527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4021",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054021",
            "telephone_number": "208-240-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 ALVIN RICKEN DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012727",
            "telephone_number": "208-233-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLADENKA",
        "first_name": "CHRISTINE",
        "middle_name": "FUHRMAN",
        "credential": "DNP, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ID",
            "license": "NP-338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "MLADENKA",
            "credential": "DNP, WHNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amillia Mitchell
• Stefanie Mitchell
• Tanya Mitchell, DO
• Mya S Mitton
• Ayano Mizote, PHARM.D
• Modern Smiles Pocatello PC
• Micah Moeai, M.S., ATC
• Kelly Mitten Moellmer
• Diane K. Moll
• Mary Paul Moller, LMFT

• Women's Health Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Women's Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.