NPI age
19 years
Enumerated 2006-09-15
Across 1280 active nurse practitioner providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807684700 | |
| 01 (WA) | G000301387 | MEDICARE GROUP |
| 01 (ID) | P00390223 | MEDICARE RAILROAD CARRIER |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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