NPI age
8 years
Enumerated 2018-02-06
● Active Type 2 · Organization
Evergreen Physical Medicine, Llc
Evergreen Physical Medicine, Llc is 1 of 1280 nurse practitioner organizations in Idaho.
Primary specialty
Nurse Practitioner
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dance
Executive Director
Last NPPES update
2018-02-06
Source: monthly bulk 2026-05
How this organization compares
Across 1280 active nurse practitioner providers in Idaho.
NPI age
8 years
≈ at median (7 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2018 → 2026
2018-02Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
1710 W Cherry Ln
Meridian, ID 836421340
Mailing address
1710 W Cherry Ln
Meridian, ID 836421340
Authorized official
Summer Dance
Executive Director
📞 2088958595
Individual providers at this organization
1 individual provider on file at this primary practice address.
- N Dahl, D.C. Chiropractor NPI 1043399363
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Evergreen Physical Medicine
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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