Organization
BLUE LAKES MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD RUSTY ARRINGTON FNP-C, DC (PROVIDER / OWNER)
(208) 734-9531
Entity
Organization
Contact information
Practice address
1122 EASTLAND DR N, STE 2, TWIN FALLS, ID 83301-8444
(208) 734-9531
(208) 733-6969
Mailing address
1122 EASTLAND DR N, STE 2, TWIN FALLS, ID 83301-8444
(208) 734-9531
(208) 733-6969
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1688A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1374328
MEDICARE PTAN
ID
Enumeration date
02/26/2016
Last updated
02/26/2016
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