Meridian Physical Medicine

NPI #1881144780 in Meridian, Idaho

Provider Information

NPI Number
1881144780
Entity Type
Organization
Organization Name
Meridian Physical Medicine
Primary Specialty
Nurse Practitioner
Enumeration Date
Oct 4, 2016
Last Updated
Oct 4, 2016

Practice Location

Address
2016 S EAGLE RD
Address 2
SUITE B
State
Idaho
ZIP Code
83642-6707
Phone
(208) 887-6810

Authorized Official

Name
MAKAYLA RUNYAN
Title
VICE PRESIDENT
Phone
(208) 887-6810

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner

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