| NPI | 1568260750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON STEPHENSON Nurse Practitioner 208-850-8440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-03-04 |
| Last Update Date | 2025-03-04 |