| NPI | 1023189800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY ANN HALL Owner 208-736-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP717A) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |