| NPI | 1902372493 |
|---|---|
| Doing Business As | POPHEALTHCARE MEDICAL SERVICES OF ID, LLC |
| Entity Type | Organization |
| Authorized Contact | KIRK STANLEY Chief Financial Officer 615-721-7023 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |