NPI age
20 years
Enumerated 2005-09-26
Across 56 active nurse practitioner providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806388600 | |
| 01 (ID) | 000010139267 | REGENCE BLUE SHIELD |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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