NPI age
12 years
Enumerated 2013-12-20
Across 15 active clinical nurse specialist providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | CS34304 | PRACTITIONER CONTROLLED SUBSTANCE |
| 01 (ID) | MO3095139 | CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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