| 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 |