NPI age
16 years
Enumerated 2009-10-09
Across 1280 active nurse practitioner providers in Idaho.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (MS) | 00534527 | |
| 05 (OR) | 500830485 |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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