NPI age
19 years
Enumerated 2007-04-10
● Active
Type 1 · Individual
Audra J Rose, PA
Rose is 1 of 27 obstetrics & gynecology providers in Idaho Falls and 1 of 228 in Idaho.
Primary specialty
Obstetrics & Gynecology
Plus 1 subspecialty
Licensed in
ID, WY
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-12-29
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 228 active obstetrics & gynecology providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 72% — 27% of peers are multi-state
Subspecialties
1
In the 42% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-04Enumerated in NPPES
2007
2026
Where they practice
Practice location
3450 Potomac Way
Idaho Falls, ID 834047407
Mailing address
3450 Potomac Way
Idaho Falls, ID 834044970
Specialties
-
Obstetrics & Gynecology PrimaryAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other...
-
Physician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807761500 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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