Organization
GEM FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH A CASDORPH FNP (FNP)
(208) 365-3455
Entity
Organization
Contact information
Practice address
1108 S WASHINGTON AVE, EMMETT, ID 83617-3535
(208) 365-3455
(208) 365-3422
Mailing address
1108 S WASHINGTON AVE, EMMETT, ID 83617-3535
(208) 365-3455
(208) 365-3422
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP238A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017986
REGENCE BLUE SHIELD
ID
01
—
NP190
BLUE CROSS
ID
Enumeration date
12/18/2006
Last updated
08/22/2020
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