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Individual

MRS. DELLISA DAWN EDDINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
6000 S 5TH AVE, POCATELLO, ID 83204-5075
(208) 478-8400
(208) 232-6018
Mailing address
6000 S 5TH AVE, POCATELLO, ID 83204-5075

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
60010
ID

Other

Enumeration date
12/08/2018
Last updated
12/08/2018
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