| NPI | 1891374898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN TRIMPE Manager 208-771-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant |
| 174N00000X Lactation Consultant, Non-RN | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |