NPI | 1720502370 |
---|---|
Entity Type | Organization |
Authorized Contact | RACHELLE JONES President 208-881-0902 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: ID Np-914A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID np-914a) |
363LF0000X Nurse Practitioner, Family (Licence: ID np-914a) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID np-914a) | |
363LW0102X Nurse Practitioner, Women's Health (Licence: np-914a) | |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology | |
Enumeration Date | 2017-07-26 |
Last Update Date | 2017-11-17 |