NPI age
13 years
Enumerated 2013-03-21
Across 374 active nurse practitioner providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 12644208 | CAQH |
| 05 (ID) | 1992858500 |
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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