MEDICARE: INSPIRING INDEPENDENCE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency	W122407	ID

General Provider Information

NPI Number	:	1568703114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRING INDEPENDENCE PLLC

Provider Business Mailing Address
First Line	:	1122 IMPERIAL ST
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-3131
Country	:	US
Telephone Number	:	208-490-4974
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 IMPERIAL ST
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-3131
Country	:	US
Telephone Number	:	208-490-4974
Fax Number	:

Authorized Official
Title or Position	:	SUPERVISER
Name	:	DANA M CLAWSON
Credential	:	RN
Telephone Number	:	208-490-4974

Provider Enumeration Date	:	03/06/2013
Last Update Date	:	03/06/2013

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