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Individual

TELIETHA ANN HAMMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
1880 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4315
(208) 524-6633
(208) 524-9952
Mailing address
1880 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4315
(208) 524-6633
(208) 524-9952

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
69144
ID

Other

Enumeration date
08/23/2021
Last updated
09/27/2021
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