IDAHO STATE UNIVERSITY
Organization (NPI-2)
Active
Nurse Practitioner, Primary Care
Provider Information
- NPI Number
1962095711- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1311 E CENTRAL DR, MERIDIAN, ID, 836427991
- Phone
- (208) 373-1734
- Fax
- (833) 499-1813
Specialties & Taxonomies
Nurse Practitioner, Primary Care
Primary