| NPI | 1215804984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH MARIE MACKEY Owner, Family Nurse Practitioner 208-255-9073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-10-18 |
| Last Update Date | 2025-10-18 |