Organization · Type 2 NPI
Olde Town Medical
Adult Health Nurse Practitioner · Meridian, ID
NPI number
1245690544
Active
Practice location
124 E Pine Ave
Meridian, ID 83642-2331
Fax (208) 888-6297
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | None listed |
Adult Health Nurse Practitioner: Definition to come...
About NPI 1245690544
Olde Town Medical's National Provider Identifier is 1245690544, issued on Feb 29, 2016. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Meridian, ID. The record was last updated on Mar 11, 2016.