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Community Care Rexburg Llc
Family Nurse Practitioner in Rexburg, Idaho
NPI 1740554237

Community Care Rexburg Llc is a Family Nurse Practitioner based in Rexburg, ID and is specialized in Family. Community Care Rexburg Llc practices in Rexburg, ID. The NPI Number for Community Care Rexburg Llc is 1740554237 and holds a License No. W 110632 (Idaho).

The current practice location address for Community Care Rexburg Llc is 72 E Main St, Rexburg, ID and can be reached out via phone at 208-525-8448 and via fax at 208-524-2749.

Location: 72 E Main St, Rexburg, ID, 83440-1926
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740554237
Provider Name
Community Care Rexburg Llc
Credential
Provider Entity Type
Organization
Address
72 E Main St, Rexburg, ID, 83440-1926
Phone Number
208-525-8448
Fax Number
208-524-2749
Provider Enumeration Date
02/29/2012
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
72 E Main St
City
Rexburg
State
Idaho
Zip
83440-1926
Phone Number
208-525-8448
Fax Number
208-524-2749
person
Provider Business Mailing Address Details
Address
72 E Main St
City
Rexburg
State
Idaho
Zip
83440-1926
Phone Number
208-525-8448
Fax Number
208-524-2749
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
W 110632 (Idaho)
Definition
Definition to come...
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