Individual
NICULINA BISTRICEANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
7615 MADDEN DR, NAMPA, ID 83686-9425
(208) 440-1085
Mailing address
7615 MADDEN DR, NAMPA, ID 83686-9425
(208) 440-1085
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
38220
ID
363L00000X
Nurse Practitioner
64875
ID
363LF0000X
Family Nurse Practitioner
Primary
64875
ID
Other
Enumeration date
01/10/2019
Last updated
02/05/2021
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