# TARTER FAMILY MEDICINE INC

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

## Provider details

- **NPI number:** 1972972446
- **Authorized official:** DAN TARTER (OWNER)
- **Authorized official phone:** (208) 880-8919

## Contact information

- **Practice address:** 1560 N CRESTMONT DR STE A, MERIDIAN, ID 83642-2178
- **Practice address phone:** (208) 650-4888
- **Practice address fax:** (208) 650-4892
- **Mailing address:** 1560 N CRESTMONT DR STE A, MERIDIAN, ID 83642-2178
- **Mailing address phone:** (208) 650-4888
- **Mailing address fax:** (208) 650-4892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | NP439A | ID | Yes |

## Other

- **Enumeration date:** 09/15/2015
- **Last updated:** 09/18/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1275631244 | INDIVIDUAL NPI | ID |