Individual
NIKOLA CHARLEEN RADLACH-BARNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 N HOLMES AVE, IDAHO FALLS, ID 83401-3200
(208) 613-0250
Mailing address
1650 N HOLMES AVE, IDAHO FALLS, ID 83401-3200
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
202740
ID
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
11/17/2025
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