Individual
NOREEN A. WOMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
450 W STATE ST, SUITE 100, EAGLE, ID 83616-7057
(208) 939-1035
(208) 939-8970
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M8127
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805831200
—
ID
Enumeration date
06/17/2006
Last updated
09/23/2012
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