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Individual

DANIEL RULON ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
715 BRAMPTON DR, CALDWELL, ID 83605-6887
(208) 960-0559
Mailing address
715 BRAMPTON DR, CALDWELL, ID 83605-6887
(208) 960-0559

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1361470
ID

Other

Enumeration date
08/23/2024
Last updated
08/23/2024
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