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Individual

MARCELA AZEVEDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
45 COTTONWOOD CT, EAGLE, ID 83616-6577
(208) 648-4100
Mailing address
45 COTTONWOOD CT STE 140, EAGLE, ID 83616-6577
(208) 648-4100

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9681016
ID

Other

Enumeration date
06/15/2026
Last updated
06/15/2026
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