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NPI Code Detail

MEDICARE: ALEXIS GABRIELLE TOVAR BS

MEDICARE: ALEXIS GABRIELLE TOVAR BS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1699601989
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS GABRIELLE TOVAR BS
Provider Business Mailing Address
First Line : 1893 W MARSH CREEK WAY
Second Line :
City : NAMPA
State : ID
Zip : 83686-5394
Country : US
Telephone Number : 208-989-3324
Fax Number :
Provider Business Practice Location Address
First Line : 709 DEARBORN ST
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4116
Country : US
Telephone Number : 208-376-7083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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