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General NPI Number Information
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NPI Number | 1790291276
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Entity Type | Organization
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Legal Business Name | BEE HAPPY PEDIATRICS
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 3412 S 25TH E
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City | IDAHO FALLS
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State | ID
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Zip | 83404-4967
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Country | US
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Telephone | 208-497-0680
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Fax | 208-497-0650
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Provider Business Mailing Address
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Address Line | 3412 S 25TH E
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City | IDAHO FALLS
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State | ID
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Zip | 83404-4967
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Country | US
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Telephone | 208-497-0680
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Fax | 208-497-0650
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DEBORAH A HILL
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Credential | CPNP
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Telephone | 208-497-0680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 57138
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License Number State | ID
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