NPI | 1639561889 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER PAULSON Family Nurse Practitioner 208-607-3738 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 201050195NP) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2015-02-25 |
Last Update Date | 2023-12-22 |