Individual
SAMANTHA DE BRUYN KOPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
2065 E 17TH ST STE C, IDAHO FALLS, ID 83404-8042
(208) 522-6106
Mailing address
6405 S 3000 E STE 201, SALT LAKE CITY, UT 84121-6990
(801) 266-3113
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61296
ID
Other
Enumeration date
05/02/2019
Last updated
02/05/2024
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