Organization
NORTH CENTRAL DISTRICT HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL M MOEHRLE RN (DIRECTOR)
(208) 799-3100
Entity
Organization
Contact information
Practice address
215 10TH ST, LEWISTON, ID 83501-1912
(208) 799-0349
Mailing address
215 10TH ST, LEWISTON, ID 83501-1912
(208) 799-0349
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
ID
363L00000X
Nurse Practitioner
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002472500
—
ID
01
—
1013936541
TRICARE
ID
01
—
600002216
UNITED HEALTHCARE-RAILROAD MEDICARE
ID
05
—
7025661
—
WA
05
—
7901309
—
WA
05
—
805022000
—
ID
05
—
806173900
—
ID
Enumeration date
07/18/2006
Last updated
07/21/2022
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