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NPI Profile for ELIZABETH BALLEWEG in BOISE, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1295372308 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 12/09/2019 | |
| Last updated | 12/09/2019 - About 6 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ELIZABETH BALLEWEG
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ELIZABETH BALLEWEG