| NPI | 1922891597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE READ Credentialing Consultant 208-605-3662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-27 |