Individual
BRYCE WADE ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
3385 POTOMAC WAY, IDAHO FALLS, ID 83404-4978
(208) 522-7246
Mailing address
690 N 700 E, FIRTH, ID 83236-1134
(208) 521-3870
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP1303A
ID
Other
Enumeration date
07/30/2013
Last updated
03/11/2024
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