Individual provider · Type 1 NPI
Olivia Southard Mayfield, AGPCNP-BC
Gerontology Nurse Practitioner · Meridian, ID
NPI number
1063125672
Active
Practice location
3015 E Magic View Dr Ste 130
Meridian, ID 83642-3750
Fax (208) 482-5515
Mailing address
3843 W Riva Capri St
Meridian, ID 83646-6739
Other practice locations
- 4842 N Cortona Way, Meridian, ID 83646-3171 · (208) 579-2024
- 7979 W Rifleman St, Boise, ID 83704-9066 · (208) 482-5530
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 74554 (ID) |
Gerontology Nurse Practitioner: Definition to come...
Other gerontology nurse practitioner providers in Meridian
About NPI 1063125672
Olivia Southard Mayfield, AGPCNP-BC's National Provider Identifier is 1063125672, issued on Dec 28, 2022. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Meridian, ID. The record was last updated on Dec 28, 2022.