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Individual

CHELSEA BRIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2990 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 535-0440
Mailing address
13862 N 175 E, RIRIE, ID 83443-5009
(503) 828-8623

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
54964
ID

Other

Enumeration date
02/17/2022
Last updated
02/17/2022
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