institution
Blue Lakes Medicine Pa
Family Nurse Practitioner in Twin Falls, Idaho
NPI 1063872489

Blue Lakes Medicine Pa is a Family Nurse Practitioner based in Twin Falls, ID and is specialized in Family. Blue Lakes Medicine Pa practices in Twin Falls, ID. The NPI Number for Blue Lakes Medicine Pa is 1063872489 and holds a License No. NP-1688A (Idaho).

The current practice location address for Blue Lakes Medicine Pa is 1122 Eastland Dr N, Twin Falls, ID and can be reached out via phone at 208-734-9531 and via fax at 208-733-6969.

Location: 1122 Eastland Dr N, Twin Falls, ID, 83301-8444
institution
Provider Profile Details
NPI Number
1063872489
Provider Name
Blue Lakes Medicine Pa
Credential
Provider Entity Type
Organization
Address
1122 Eastland Dr N, Twin Falls, ID, 83301-8444
Phone Number
208-734-9531
Fax Number
208-733-6969
Provider Enumeration Date
02/26/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1374328 01 ID MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1122 Eastland Dr N
City
State
Zip
83301-8444
Phone Number
208-734-9531
Fax Number
208-733-6969
person
Provider Business Mailing Address Details
Address
1122 Eastland Dr N
City
State
Zip
83301-8444
Phone Number
208-734-9531
Fax Number
208-733-6969
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
NP-1688A (Idaho)
Definition
Definition to come...
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