Individual
BIANCA MARTINEZ SCANLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2561 W SELTICE WAY, POST FALLS, ID 83854-8093
(208) 981-0132
Mailing address
13820 N LAUREN LOOP UNIT 1, RATHDRUM, ID 83858-8844
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
F341979-1
NY
363L00000X
Nurse Practitioner
Primary
69796
ID
Other
Enumeration date
11/13/2017
Last updated
01/07/2022
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