Garnet State Enterprises LLC
NPI #1184433005 in Hayden, Idaho
Provider Information
- NPI Number
- 1184433005
- Entity Type
- Organization
- Organization Name
- Garnet State Enterprises LLC
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Jan 6, 2025
- Last Updated
- Jan 6, 2025
Practice Location
Authorized Official
- Name
- MR. PETER GORDON GOURLEY, ARNP
- Title
- PSYCHIATRIC NURSE PRACTITIONER
- Phone
- (208) 518-9927
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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