| NPI | 1598578569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HARCOURT Business Owner, Provider 208-220-3886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-03-19 |