Grand Teton Gastroenterology

NPI #1457520900 in Idaho Falls, Idaho

Provider Information

NPI Number
1457520900
Entity Type
Organization
Organization Name
Grand Teton Gastroenterology
Primary Specialty
Nurse Practitioner
Enumeration Date
Feb 28, 2008
Last Updated
Feb 29, 2008

Practice Location

Address
2770 CORTEZ AVE
State
Idaho
ZIP Code
83404-7590
Phone
(208) 522-4000

Authorized Official

Name
MRS. MELISSA DAWN LEMONS, CCS-P
Title
BILLING MANAGER
Phone
(208) 528-4255

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner

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