NPI age
8 years
Enumerated 2017-06-02
Across 1280 active nurse practitioner providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | AP60750903 | STATE LICENSE |
| 01 (ID) | 71512 | LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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