Healthcare Provider Details

I. General information

NPI: 1497953376
Provider Name (Legal Business Name): KATHERINE I ABERLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 RIVERWALK DR STE 100
IDAHO FALLS ID
83402-3304
US

IV. Provider business mailing address

PO BOX 1300
COEUR D ALENE ID
83816-1300
US

V. Phone/Fax

Practice location:
  • Phone: 208-704-0905
  • Fax:
Mailing address:
  • Phone: 208-704-0905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberM-16772
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: