Individual
SKYLER MICOL DORIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1641 COBBLESTONE AVE, CHUBBUCK, ID 83202-5243
(208) 760-9238
Mailing address
1641 COBBLESTONE AVE, CHUBBUCK, ID 83202-5243
(208) 760-9238
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71861
ID
Other
Enumeration date
03/07/2022
Last updated
03/09/2022
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