NPI age
4 years
Enumerated 2021-11-13
Across 79 active nurse practitioner providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (OR) | 202002437RN | RN LICENSE |
| 01 (ID) | 53726 | NURSING LICENSE |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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