Organization
POCATELLO CARDIOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE P CONOLEY (CLINIC ADMINSTRATOR)
(208) 234-2001
Entity
Organization
Contact information
Practice address
777 HOSPITAL WAY BLDG A, STE. 101, POCATELLO, ID 83201-2753
(208) 234-2001
(208) 232-2195
Mailing address
PO BOX O, POCATELLO, ID 83205-0049
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806402400
—
ID
Enumeration date
02/28/2008
Last updated
11/14/2008
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