Anna Marie Garvin, RN

Individual provider Active NPI General Practice Registered Nurse · Mountain Home, ID

NPI 1174149264 · NPPES record last updated Jun 24, 2020

Key facts

NPI
1174149264
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
51315 (ID)
Practice address
815 N 6TH E
Mountain Home, ID 83647-2207
Phone
(208) 580-2001
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
51315IDMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 51315 ID Yes

Addresses

Primary practice location

815 N 6TH E
Mountain Home, ID 83647-2207

Mailing address

815 N 6TH E
Mountain Home, ID 83647-2207
Phone (208) 580-2001

Other providers in Mountain Home, ID

All providers in Mountain Home, ID · General Practice Registered Nurse in Idaho

Sources for this page

Verify at the official NPI Registry.