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Organization
FAMILY MEDICINE HUB PLLC
Active
Organization
FAMILY MEDICINE HUB PLLC
Active
Other names
Blair Family Medicine, Blair Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY CAMERON (PRACTICE MANAGER)
(208) 357-4633
Entity
Organization
Contact information
Practice address
2001 S WOODRUFF AVE STE 15B, IDAHO FALLS, ID 83404-6372
(208) 357-4633
(208) 419-0690
Mailing address
2001 S WOODRUFF AVE STE 15B, IDAHO FALLS, ID 83404-6372
(208) 357-4633
(208) 419-0690
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629128483
—
ID
Enumeration date
02/26/2018
Last updated
11/12/2024
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