Individual
AMY CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN CPNP
Contact information
Practice address
3412 S 25TH E, IDAHO FALLS, ID 83404-4967
(208) 497-0680
Mailing address
3412 S 25TH E, IDAHO FALLS, ID 83404-4967
(208) 710-9200
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
69247
ID
Other
Enumeration date
04/18/2022
Last updated
05/06/2022
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