Individual
MARGARET K MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 322-7018
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 322-7018
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP349A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806976800
—
ID
Enumeration date
05/08/2006
Last updated
02/14/2011
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