| NPI | 1124354519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LANNIE CHECKETTS CFO & Board Member 208-367-7347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2023-01-24 |