Individual
MRS. AMY DIANA THORNLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 589-6111
(208) 529-7021
Mailing address
PO BOX 277381, ATLANTA, GA 30384-7381
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP-1158A
ID
363LA2100X
Acute Care Nurse Practitioner
NP-1158A
ID
Other
Enumeration date
10/10/2012
Last updated
06/07/2021
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