NPI age
19 years
Enumerated 2006-06-26
Across 658 active nurse practitioner providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P01032142 | MCRR |
| 05 (ID) | 805065200 |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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