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1063786648
TENNESSEE PHS PC
BOISE, ID
NPI
1063786648
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Entity Type
Organization
Authorized Contact
NICOLE HOWARD
CFO
337-991-9276
Organization Subpart ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
Enumeration Date
2012-02-29
Last Update Date
2014-07-02
Business Address
TENNESSEE PHS PC
950 W. BANNOCK STREET SUITE 1100
BOISE, ID 83702-6140
Phone number: 877-260-4747
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Mailing Address
TENNESSEE PHS PC
1509 DULLES DRIVE
LAFAYETTE, LA 70506
Phone number: 337-991-9276
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