Organization · Type 2 NPI
Bespoke Body & Wellness
Family Nurse Practitioner · Meridian, ID
NPI number
1104680602
Active
Practice location
4028 N Quenzer Way
Meridian, ID 83646-5928
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
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About NPI 1104680602
Bespoke Body & Wellness's National Provider Identifier is 1104680602, issued on Feb 6, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Meridian, ID. The record was last updated on Feb 6, 2024.