East To West Medicine | |
2051a E Summersweet Dr Boise ID 83716 | |
(208) 908-1041 | |
Not Available |
Full Name | East To West Medicine |
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Speciality | Nurse Practitioner |
Location | 2051a E Summersweet Dr, Boise, Idaho |
Authorized Official Name and Position | Kathleen Lewis (MANAGER) |
Authorized Official Contact | 2089558215 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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East To West Medicine 2051a E Summersweet Dr Boise ID 83716-6695 Ph: (208) 395-1090 | East To West Medicine 2051a E Summersweet Dr Boise ID 83716 Ph: (208) 908-1041 |
NPI Number | 1801393616 |
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Provider Enumeration Date | 04/09/2018 |
Last Update Date | 06/16/2018 |
Medicare PECOS PAC ID | 0143578674 |
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Medicare Enrollment ID | O20180731002910 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801393616 | NPI | - | NPPES |
1265834311 | Medicaid | ID |
Provider Name | Leanna Moser |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265834311 PECOS PAC ID: 3779808381 Enrollment ID: I20150202001278 |
Provider Name | Katherine Elizabeth Turnbull |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225460066 PECOS PAC ID: 6305185463 Enrollment ID: I20190307000779 |
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