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General NPI Number Information
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NPI Number | 1730714049
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Entity Type | Organization
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Legal Business Name | CARE MEDICAL HOUSECALLS PC
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Dates
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Enumeration Date | 03/06/2020
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 2040 E HOLGATE CT
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City | EAGLE
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State | ID
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Zip | 83616
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Country | US
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Telephone | 208-991-0145
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1804
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City | EAGLE
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State | ID
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Zip | 83616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER / OWNER
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Name | MARY ROEHLING
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Credential |
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Telephone | 208-860-1398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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