| NPI | 1225057813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL M MOEHRLE Director 208-799-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-07-21 |