Healthcare Provider Details

I. General information

NPI: 1033782982
Provider Name (Legal Business Name): SARAH GARBER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 W FRANKLIN RD STE 108
BOISE ID
83705-6433
US

IV. Provider business mailing address

333 W CEDAR ST STE 3
POCATELLO ID
83201-5045
US

V. Phone/Fax

Practice location:
  • Phone: 208-283-7314
  • Fax: 208-550-3204
Mailing address:
  • Phone: 208-252-5621
  • Fax: 208-648-4167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number65217
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: