Lookup NPI Numbers from the NPI Registry
NPI Profile for BLUE LAKES MEDICINE PA in TWIN FALLS, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1063872489 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/26/2016 | |
| Last updated | 02/26/2016 - About 10 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BLUE LAKES MEDICINE PA
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BLUE LAKES MEDICINE PA