Individual
MRS. DENISE LORAINE BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1970 E 17TH ST STE 111B, IDAHO FALLS, ID 83404-8046
(208) 541-5257
Mailing address
4710 CUMBERLAND DR, IDAHO FALLS, ID 83404-8414
(208) 716-6445
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NP-1643A
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-1643A
ID
Other
Enumeration date
11/02/2006
Last updated
05/29/2024
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