| NPI | 1437783529 |
|---|---|
| Former Legal Business Name | PSYCHIATRIC NURSE PRACTITIONER SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | SUSAN M DERIVAS AO 208-775-7418 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2024-02-07 |