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General NPI Number Information
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NPI Number | 1457029639
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Entity Type | Organization
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Legal Business Name | ZORA NEUROSPA, LLC
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 1000 N CURTIS RD STE 202
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City | BOISE
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State | ID
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Zip | 83706-1346
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Country | US
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Telephone | 208-648-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N CURTIS RD STE 202
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City | BOISE
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State | ID
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Zip | 83706-1346
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Country | US
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Telephone | 208-648-4100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CAREY CRILL
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Credential | ARNP-C
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Telephone | 208-284-4533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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