Individual
MRS. RAEMI DAWN NOLEVANKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-1000
Mailing address
2522 E 3810 N, TWIN FALLS, ID 83301-5549
(208) 731-9841
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
56430
ID
Other
Enumeration date
02/08/2023
Last updated
08/07/2023
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