IDAHO STATE UNIVERSITY; NPI #1962095711

Contact Information

IDAHO STATE UNIVERSITY

1311 E CENTRAL DR
MERIDIAN, ID 83642-7991

Phone: 208-373-1734
Fax: 833-499-1813
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	363LP2300X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for IDAHO STATE UNIVERSITY

NPI Number	`1962095711`
LBN Legal business name	IDAHO STATE UNIVERSITY
Authorized official	CYNTHIA ROCK - (CLINICS DIRECTOR OF OPERATIONS)
Entity	Organization
Organization subpart ¹	No
Enumeration date	02/12/2021
Last updated	08/27/2021 - About 5 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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