Grand Teton Gastroenterology

NPI 1457520900 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1457520900
Enumeration Date 02/28/2008
Last Updated 02/29/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name MELISSA DAWN MELISSA
Position BILLING MANAGER
Phone (208) 522-4000
Fax (208) 528-4242
Practice Location
2770 CORTEZ AVE
IDAHO FALLS ID, 83404-7590, US
Phone (208) 522-4000
Fax (208) 528-4242
Business Location
2770 CORTEZ AVE
IDAHO FALLS ID, 83404-7590, US
Phone (208) 522-4000
Fax (208) 528-4242
Toxanomy
Taxonomy Code 363L00000X
License State
License Number
Remove 1457520900 NPI Number
 

According to our database, Grand Teton Gastroenterology NPI is 1457520900, taxonomy code is 363L00000X Grand Teton Gastroenterology physically located at 2770 Cortez Ave, Idaho Falls ID, 83404-7590. NPI Number 1033115704 has the healthcare provider type.

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1457520900 NPI number is provided on an as is basis without warranty of any kind. 1457520900 is maintained by the National Plan & Provider Enumeration System. The contents of Grand Teton Gastroenterology are for informational purposes only.