Idaho County Dermatology, Pllc
NPI #1922835859 in Grangeville, Idaho
Provider Information
- NPI Number
- 1922835859
- Entity Type
- Organization
- Organization Name
- Idaho County Dermatology, Pllc
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Sep 16, 2024
- Last Updated
- Feb 7, 2025
Practice Location
- Address
- 113 S A ST
- City
- Grangeville
- State
- Idaho
- ZIP Code
- 83530-1428
- Phone
- (208) 695-6668
Authorized Official
- Name
- JEANNA RENDO, NP-C
- Title
- OWNER/PROVIDER
- Phone
- (208) 695-6668
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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