Individual
MARY BETH ROEHLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2040 E HOLOGATE CT, EAGLE, ID 83616
(208) 866-6840
(949) 577-4700
Mailing address
PO BOX 1804, EAGLE, ID 83616
(208) 866-6840
(949) 577-4700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-1230A
ID
Other
Enumeration date
12/03/2012
Last updated
06/30/2020
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