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General NPI Number Information
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NPI Number | 1780295675
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Entity Type | Organization
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Legal Business Name | PALOUSE VIRTUAL CARE, LLC
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 513 HARVEST LOOP
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City | PALOUSE
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State | WA
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Zip | 99161-5101
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Country | US
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Telephone | 509-402-1898
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Fax | 509-878-3126
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Provider Business Mailing Address
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Address Line | 513 HARVEST LOOP
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City | PALOUSE
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State | WA
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Zip | 99161-5101
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Country | US
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Telephone | 509-402-1898
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Fax | 509-878-3126
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Authorized Official
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Title or Position | OWNER, FAMILY NURSE PRACTITIONER
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Name | TONYA M HOLSTEIN
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Credential | MSN,FNP-C
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Telephone | 509-402-1898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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