Individual
HEATHER CROSSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1675 E RIVERSIDE DR STE 200, EAGLE, ID 83616-7473
(385) 427-1570
Mailing address
1675 E RIVERSIDE DR STE 200, EAGLE, ID 83616-7473
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
66212
ID
390200000X
Student in an Organized Health Care Education/Training Program
N-28059
ID
Other
Enumeration date
11/13/2016
Last updated
05/05/2024
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