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Individual

JOSIE F FARMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
4740 N PENNGROVE WAY, STE 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664
Mailing address
4740 N PENNGROVE WAY, STE 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP 936A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1349042
MEDICARE PTAN
ID
05
808552900
ID
Enumeration date
10/05/2009
Last updated
08/26/2019
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