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General NPI Number Information
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NPI Number | 1720296262
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Entity Type | Individual
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Provider Name | FRANCESCA LINDSAY GREGG COTA L
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 703 AMERICANA BLVD
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City | BOISE
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State | ID
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Zip | 83702-6754
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Country | US
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Telephone | 208-672-1836
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Fax |
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Provider Business Mailing Address
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Address Line | 11699 W POWDERHORN CT
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City | BOISE
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State | ID
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Zip | 83713-4704
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Country | US
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Telephone | 208-376-3433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OTA-195
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License Number State | ID
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