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NPI Code Detail

MEDICARE: ERICA L SOMMER

MEDICARE: ERICA L SOMMER
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
1363LF0000XFamily Nurse Practitioner54407ID

General Provider Information

NPI Number : 1720794399
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA L SOMMER
Provider Business Mailing Address
First Line : 1170 CONNER CT
Second Line :
City : KIMBERLY
State : ID
Zip : 83341-5139
Country : US
Telephone Number : 702-275-5281
Fax Number :
Provider Business Practice Location Address
First Line : 1525 ADDISON AVE E STE A2
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-5300
Country : US
Telephone Number : 208-739-9961
Fax Number : 208-739-9962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2023
Last Update Date : 08/07/2024

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Directions to “ ERICA L SOMMER ” Practice Location

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