Gifford, Laura Marie

Gifford, Laura Marie is an individual health care provider with primary practice located at 415 6Th St , Lewiston ID 83501-2431. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Gifford, Laura Marie can be contacted via phone (208) 743-2511.

Contact Information

Primary practice address
415 6Th St Lewiston ID 83501-2431
Phone: (208) 743-2511
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA61022472 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-1434 Idaho

Profile Details

NPI number 1265800742
LBN Legal business name Gifford, Laura Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2015
Last updated Apr 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265800742 NPPES
Washington MEDICAID 2074831

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