NPI age
19 years
Enumerated 2006-09-02
Across 658 active nurse practitioner providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 0214563 | WA DEPARTMENT OF LABOR |
| 05 (ID) | 807623700 | |
| 01 (ID) | NPXZ4 | BLUE CROSS OF ID |
| 01 (ID) | 000010157664 | BLUE SHIELD OF ID |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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