| NPI | 1003295452 |
|---|---|
| Doing Business As | ST LUKE'S HUMPHREYS DIABETES CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFF TAYLOR Sr Vice President And CFO 208-381-2520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse Diabetes Educator (Licence: ID 03) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ID 03) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2016-06-22 |