Individual
DANA VINEYARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8394 LAKE SHORE DR, NAMPA, ID 83686-9200
(208) 380-0686
Mailing address
8394 LAKE SHORE DR, NAMPA, ID 83686-9200
(208) 380-0686
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
38166
ID
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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