| NPI | 1336762566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE ELAINE ADAMS CEO 208-577-8672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-06-04 |