Lifespan Primary Care Llc

NPI 1023189800 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1023189800
Enumeration Date 11/13/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name BEVERLY ANN BEVERLY
Position OWNER
Phone (208) 736-7090
Fax (208) 736-7089
Practice Location
224 MARTIN ST
SUITE B
TWIN FALLS ID, 83301-4542, US
Phone (208) 736-7090
Fax (208) 736-7089
Business Location
224 MARTIN ST
SUITE B
TWIN FALLS ID, 83301-4542, US
Phone (208) 736-7090
Fax (208) 736-7089
Toxanomy
Taxonomy Code 363LF0000X
License State Idaho
License Number NP717A
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According to our database, Lifespan Primary Care Llc NPI is 1023189800, taxonomy code is 363LF0000X and license number is NP717A, license state is located at Idaho. Lifespan Primary Care Llc physically located at 224 Martin St, Twin Falls ID, 83301-4542. NPI Number 1033115704 has the healthcare provider type.

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1023189800 NPI number is provided on an as is basis without warranty of any kind. 1023189800 is maintained by the National Plan & Provider Enumeration System. The contents of Lifespan Primary Care Llc are for informational purposes only.