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ID PHS LLC

Organization (NPI-2) Active

Nurse Practitioner

Provider Information

NPI Number
1245613967
Provider Type
Organization / Facility (NPI-2)
Status
Active

Contact & Location

Address
950 W. BANNCOCK STREET STE 1100, BOISE, ID, 837026140
Phone
(337) 991-9276
Fax
(337) 991-9288

Specialties & Taxonomies

Nurse Practitioner, Family
Nurse Practitioner Primary

All Addresses

MAILING

1509 DULLES DR

LAFAYETTE, LA, 705063718

(337) 991-9276

LOCATION

950 W. BANNCOCK STREET STE 1100

BOISE, ID, 837026140

(337) 991-9276