Sydney Geneva Anglea

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Eagle, ID

NPI 1376246728 · NPPES record last updated Mar 24, 2023

Key facts

NPI
1376246728
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
427 South Silver Bow Avenue
Eagle, ID 83616
Phone
(208) 449-8913
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes
Athletic Trainer 2255A2300X

Addresses

Primary practice location

427 South Silver Bow Avenue
Eagle, ID 83616

Mailing address

427 South Silver Bow Avenue
Eagle, ID 83616
Phone (208) 449-8913

Other providers in Eagle, ID

All providers in Eagle, ID · Student in an Organized Health Care Education/Training Program in Idaho

Sources for this page

Verify at the official NPI Registry.