| NPI | 1487367124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE LORAINE BARNES Nurse Practitioner 208-716-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2023-01-13 |