Sperovue, LLC
Nurse Practitioner, Psych/Mental Health in Post Falls, ID. Organization (NPI-2).
NPI number1154089415
StatusActive
Last updated in NPPESDec 21, 2021
Details
- NPI
- 1154089415
- Entity type
- Organization (NPI-2)
- Legal business name
- Sperovue, LLC
- Organization subpart
- No
- Enumeration date
- Dec 3, 2021
- Certification date
- Dec 21, 2021
- Last updated
- Dec 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
784 S Clearwater Loop Ste DPost Falls, ID 83854-9599
Phone 208-615-9400
Mailing address
1311 E Central DrMeridian, ID 83642-7991
Phone 208-615-6400
Authorized official
Ryan Manwaring
Ceo
2086159400
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