| NPI | 1568136299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA ANN CAMERON Owner 208-539-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2024-05-16 |