Individual
HALEY J MINNEHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3267
(208) 962-2313
Mailing address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3267
(208) 962-2313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7798
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805196200
—
ID
Enumeration date
05/24/2005
Last updated
08/06/2021
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