Individual provider · NPI-1
Amber Woolley, IDMT
Military Health Care Provider, Independent Duty Medical Technicians · Mountain Home, ID
NPI number1922411677
StatusActive
Last updated in NPPESSep 4, 2025
Details
- NPI
- 1922411677
- Entity type
- Individual (NPI-1)
- Name
- Amber Woolley
- Credential
- IDMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2014
- Certification date
- Sep 4, 2025
- Last updated
- Sep 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1003X | Military Health Care Provider, Independent Duty Medical Technicians | – | TX | Yes |
| 1710I1003X | Military Health Care Provider, Independent Duty Medical Technicians | – | – |
Practice location
90 Hope Dr Ste 6000Mountain Home, ID 83648
Phone 208-828-7951
Mailing address
90 Hope Dr Ste 6000Mountain Home, ID 83648
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