Individual
DEANNA RACHEL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1510 12TH AVE RD, NAMPA, ID 83686-6008
(208) 302-6800
(208) 302-6855
Mailing address
1510 12TH AVE RD, NAMPA, ID 83686-6008
(208) 302-6800
(208) 302-6855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
76326
ID
363LF0000X
Family Nurse Practitioner
Primary
76326
ID
Other
Enumeration date
06/02/2023
Last updated
06/30/2023
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