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General NPI Number Information
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NPI Number | 1083578413
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Entity Type | Individual
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Provider Name | MRS. EMMA ANDREASEN
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Gender | Female
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 625 POLE LINE RD W STE 2A
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City | TWIN FALLS
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State | ID
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Zip | 83301-4270
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Country | US
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Telephone | 208-814-7271
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Fax |
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Provider Business Mailing Address
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Address Line | 1769 GAGE AVE
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City | TWIN FALLS
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State | ID
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Zip | 83301-0242
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Country | US
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Telephone | 208-316-5920
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 63773
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License Number State | ID
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