NPI age
12 years
Enumerated 2013-12-15
Across 658 active nurse practitioner providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1023439213 |
Part of a multi-provider practice. 161 other active providers share this practice address in NPPES.
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