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Organization

CARMEN HERNANDEZ RADFORD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARMEN HERNANDEZ RADFORD (FNP)
(208) 757-1854
Entity
Organization

Contact information

Practice address
3652 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 419-0593
Mailing address
5451 THATCHER AVE, IDAHO FALLS, ID 83404-4935
(208) 757-1854

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
NP-1660A
ID

Other

Enumeration date
12/01/2015
Last updated
12/01/2015
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