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MARCI AHLQUIST

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1376084673

Individual Registrant:
 MARCI  AHLQUIST 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
775 POLE LINE RD W SUITE 203 TWIN FALLS, ID 83301-5814 US
Tel: 208-814-8300  Fax: 208-733-8970

Contact information for business:
775 POLE LINE ROAD WEST SUITE NUMBER 203 TWIN FALLS, ID 83301 US
Tel: 208-814-8300  Fax: 208-733-8970

Registration Information:
NPI: 1376084673
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
ID55418

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS ID - Page 1

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