Organization
EAST TO WEST FAMILY MEDICINE
Active
Other names
East to West Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LEWIS (MANAGER)
(208) 955-8215
Entity
Organization
Contact information
Practice address
2051A E SUMMERSWEET DR, BOISE, ID 83716
(208) 908-1041
Mailing address
2051A E SUMMERSWEET DR, BOISE, ID 83716-6695
(208) 395-1090
(208) 395-1093
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
37185
ID
363LA2100X
Acute Care Nurse Practitioner
NP1522A
ID
363LA2200X
Adult Health Nurse Practitioner
NP1522A
ID
363LF0000X
Family Nurse Practitioner
Primary
NP1522A
ID
363LP0200X
Pediatric Nurse Practitioner
NP1522A
ID
363LP2300X
Primary Care Nurse Practitioner
NP1522A
ID
363LW0102X
Women's Health Nurse Practitioner
NP1522A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265834311
—
ID
Enumeration date
04/09/2018
Last updated
06/16/2018
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