Individual
REGINA WHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 SUNFLOWER RD, REXBURG, ID 83440-3288
(208) 530-3000
Mailing address
510 SUNFLOWER RD, REXBURG, ID 83440-3288
(208) 530-3000
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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