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General NPI Number Information
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NPI Number | 1528924842
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Entity Type | Organization
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Legal Business Name | ALPINE WELLNESS CLINIC, PLLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 5655 N GLENWOOD ST STE 105
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City | GARDEN CITY
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State | ID
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Zip | 83714-1831
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Country | US
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Telephone | 208-917-2772
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Fax | 208-375-5844
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Provider Business Mailing Address
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Address Line | 5655 N GLENWOOD ST STE 105
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City | GARDEN CITY
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State | ID
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Zip | 83714-1831
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Country | US
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Telephone | 208-917-2772
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Fax | 208-375-5844
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA CHARMAINE SANDMEYER
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Credential | NP
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Telephone | 208-447-7893
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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 |
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