Individual
ERICA MARTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W 4TH N, BURLEY, ID 83318-3421
(208) 219-4682
Mailing address
200 W 4TH N, BURLEY, ID 83318-3421
(208) 219-4682
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
ID
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
874546974
—
ID
Enumeration date
01/21/2022
Last updated
01/21/2022
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