Organization · Type 2 NPI

MMG LLC

Nurse Practitioner · Meridian, ID

NPI number 1407469166 Active

Practice location

2440 S Titanium Pl
Meridian, ID 83642-6703

Call (208) 456-2659 Map

Fax (208) 454-0854

Mailing address

450 S 900 E Ste 100
Salt Lake City, UT 84102-2983

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNone listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1407469166

MMG LLC's National Provider Identifier is 1407469166, issued on Aug 24, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Meridian, ID. The record was last updated on Jul 22, 2022.