# SUNSHINE TELEMEDICINE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558026302
- **Authorized official:** MRS. NATALIE ANN JOHNSON (MANAGER)
- **Authorized official phone:** (208) 313-2273

## Contact information

- **Practice address:** 805 JEFFERSON AVE, POCATELLO, ID 83201-3625
- **Practice address phone:** (208) 238-0400
- **Practice address fax:** (208) 238-0401
- **Mailing address:** 805 JEFFERSON AVE, POCATELLO, ID 83201-3625
- **Mailing address phone:** (208) 238-0400
- **Mailing address fax:** (208) 238-0401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2021
- **Last updated:** 12/08/2021