TENNESSEE PHS PC

BOISE, ID
NPI1063786648
Entity TypeOrganization
Authorized ContactNICOLE HOWARD
CFO
337-991-9276
Organization Subpart ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
Enumeration Date2012-02-29
Last Update Date2014-07-02
Business Address
TENNESSEE PHS PC
950 W. BANNOCK STREET SUITE 1100
BOISE, ID 83702-6140
Phone number: 877-260-4747
Mailing Address
TENNESSEE PHS PC
1509 DULLES DRIVE
LAFAYETTE, LA 70506
Phone number: 337-991-9276