# CARMEN HERNANDEZ RADFORD

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

## Provider details

- **NPI number:** 1588038616
- **Authorized official:** CARMEN HERNANDEZ RADFORD (FNP)
- **Authorized official phone:** (208) 757-1854

## Contact information

- **Practice address:** 3652 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
- **Practice address phone:** (208) 419-0593
- **Mailing address:** 5451 THATCHER AVE, IDAHO FALLS, ID 83404-4935
- **Mailing address phone:** (208) 757-1854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | NP-1660A | ID | Yes |

## Other

- **Enumeration date:** 12/01/2015
- **Last updated:** 12/01/2015