=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144168931
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBBIE J GARRETT APRN-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2026
-----------------------------------------------------
Last Update Date | 03/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8827 N GOVERNMENT WAY UNIT 106
-----------------------------------------------------
City | HAYDEN
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83835-8231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-518-1168
-----------------------------------------------------
Fax | 208-518-1278
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1021
-----------------------------------------------------
City | ATHOL
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83801-6009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-251-2660
-----------------------------------------------------
Fax | 208-251-2660
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0505X
-----------------------------------------------------
Taxonomy Name | Adult Medicine Physician
-----------------------------------------------------
License Number | 8381102
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------