Organization
SHINING LITE WEIGHT MANAGEMENT & PERSONAL SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA F BETHEL DNP, APRN, FNP (MEMBER/PROVIDER)
(208) 639-2333
Entity
Organization
Contact information
Practice address
4483 N DRESDEN PL STE 102, GARDEN CITY, ID 83714-5092
(208) 639-2333
(208) 957-5769
Mailing address
8700 W ATWATER DR, GARDEN CITY, ID 83714-1299
(208) 559-4597
(208) 957-5769
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/23/2019
Last updated
06/11/2019
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