| NPI | 1083932396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A DURKIN Credentialing Manager 208-664-4026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP30006441) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60081731) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |