Individual
LAIRA LUE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
401 W CAMAS AVE, FAIRFIELD, ID 83327
(208) 764-2611
(208) 764-2646
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 734-3312
(208) 734-3313
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-327A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805065000
—
ID
Enumeration date
05/03/2006
Last updated
11/27/2012
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