| NPI | 1962095711 |
|---|---|
| Other Name | ISU MERIDIAN HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LEE ROCK Clinics Director Of Operations 208-373-1743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-08-27 |