Organization · Type 2 NPI
Idaho State University
Primary Care Nurse Practitioner · Meridian, ID
NPI number
1962095711
Active
Practice location
1311 E Central Dr
Meridian, ID 83642-7991
Fax (833) 499-1813
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1962095711
Idaho State University's National Provider Identifier is 1962095711, issued on Feb 12, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Meridian, ID. The record was last updated on Aug 27, 2021.