NPI age
12 years
Enumerated 2013-08-31
Across 56 active nurse practitioner providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | AG0613029 | NURSE PRACTITIONER CERTIFICATION |
| 01 (ID) | NP-1326A | LICENSE NUMBER |
Solo or small practice. No other active providers share this practice address in NPPES.
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