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General NPI Number Information
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NPI Number | 1811725088
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Entity Type | Organization
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Legal Business Name | DOCTOR OF NURSING PRACTICE PRIMARY CARE LLC
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 3904 E MULLAN AVE STE C
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City | POST FALLS
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State | ID
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Zip | 83854-4009
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Country | US
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Telephone | 208-786-0569
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Fax |
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Provider Business Mailing Address
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Address Line | 1869 E SELTICE WAY # 365
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City | POST FALLS
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State | ID
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Zip | 83854-7019
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Country | US
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Telephone | 208-786-0569
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Fax | 833-973-4009
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ANDREA LYNN GAREY
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Credential | DNP, FNP-C
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Telephone | 208-786-0569
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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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