| NPI | 1558109553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DAWN BARTLETT Owner 208-738-3446 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |