| NPI | 1013256379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA LABORDE Owner/Provider 208-994-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: ID N-27344) |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2022-10-04 |