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NPI 1053469551

NPI 1053469551 : REBECCA K STONE ANPC : BOISE, ID

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General NPI Number Information
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    NPI Number           |    1053469551
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA K STONE ANPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/08/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    223 W STATE ST 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83702-6013
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    Country              |    US
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    Telephone            |    208-429-1627
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    223 W STATE ST 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83702-6013
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    Country              |    US
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    Telephone            |    208-429-1627
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LA2200X
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    Taxonomy Name        |    Adult Health Nurse Practitioner
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    License Number       |    NP174-A
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    License Number State |    ID
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