Individual
LAURA J MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1995 E 17TH ST STE 2, IDAHO FALLS, ID 83404-6493
(208) 529-2352
(208) 528-3332
Mailing address
PO BOX 1547, IDAHO FALLS, ID 83403-1547
(208) 529-2352
(208) 528-3332
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP386A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805725800
—
ID
01
—
P00152836
RAILROAD MEDICARE
—
Enumeration date
10/24/2006
Last updated
02/03/2012
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