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General NPI Number Information
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NPI Number | 1477750032
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTHCARE ASSOCIATES
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 2327 CORONADO ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7407
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Country | US
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Telephone | 208-557-2900
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Fax | 208-557-4973
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Provider Business Mailing Address
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Address Line | 2327 CORONADO ST
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7407
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Country | US
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Telephone | 208-557-2981
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Fax | 208-557-2910
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. SANDRA E GNEITING
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Credential |
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Telephone | 208-557-2910
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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 | NP607A
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA410
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License Number State | ID
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