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General NPI Number Information
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NPI Number | 1225057813
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 215 10TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-1912
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Country | US
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Telephone | 208-799-0349
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Fax |
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Provider Business Mailing Address
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Address Line | 215 10TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-1912
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Country | US
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Telephone | 208-799-0349
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CAROL M MOEHRLE
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Credential | RN
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Telephone | 208-799-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State | ID
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