| NPI | 1750920401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LAPLANTE Owner 208-635-5265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2019-12-29 |
| Last Update Date | 2020-04-07 |