| NPI | 1659540292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE P CONOLEY Clinic Adminstrator 208-234-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-11-14 |