Asthma & Allergy of Idaho
NPI #1265635171 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1265635171
- Entity Type
- Organization
- Organization Name
- Asthma & Allergy of Idaho
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Jun 7, 2007
- Last Updated
- Jan 14, 2021
Practice Location
- Address
- 1502 LOCUST ST N STE 600
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-4164
- Phone
- (208) 734-6091
Authorized Official
- Name
- ANDREW WICKERN
- Title
- CREDENTIALING SPECIALIST
- Phone
- (208) 734-6091
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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